Lawmakers advance Reynolds’ proposal for submitting state-based health insurance waiver

House lawmakers advanced a proposal by Gov. Kim Reynolds to submit a waiver to the Centers for Medicare and Medicaid Services as the first step to establish state-based health insurance in Iowa.

The proposal, House Study Bill 721, is one of Reynolds' legislative priorities, as she says federal health insurance under the Affordable Care Act continues to remain expensive and uncertain.

Reynolds' Chief of Staff Molly Severn said a state-run program would lower health insurance costs for Iowans after an expiration of enhanced ACA subsidies caused premiums to skyrocket for many.

"If Congress is unable to fix the Affordable Care Act, Iowa must explore opportunities to reduce costs at the state level," Severn said during a meeting subcommittee Thursday morning.

A similar effort was attempted in 2017, when Iowa lawmakers tried to establish a similar state-run system, but it was unsuccessful.

Multiple representatives for health insurance companies and groups remained either undecided or in support of the legislation.

Democratic Rep. Austin Baeth of Des Moines questioned Reynolds' staff during the subcommittee meeting on whether there would be more oversight of the waiver submission, which would be solely handled by the Iowa insurance commissioner under the bill. He suggested that there be a broader advisory committee overseeing the waiver submission.

Baeth, who sat on the three-member subcommittee, declined to advance the legislation. Republican Reps. Brett Barker of Nevada and Shannon Lundgren of Peosta agreed to advance the bill.