Number of Iowans picking federal health plans steadily increasing

Doug Ommen, Iowa's insurance commissioner, said the marketplace — which was created by the federal Affordable Care Act — in Iowa has developed an equilibrium and is providing "a fair amount of coverage."

Ommen, however, also expressed concern that the market is becoming increasingly reliant upon federal financial assistance to make the insurance plans affordable.

The next open enrollment period for the federal marketplace starts Nov. 1.

"I'd say the market is finding its new equilibrium," Ommen said Tuesday. "We've had some stable participation for a number of years now from carriers, and we've got options for people on the individual market again this year."

According to the Kaiser Family Foundation, a not-for-profit that advocates for and conducts research on health care, the number of Iowans who have selected marketplace plans steadily has risen since 2014.

More than 72,000 Iowans enrolled in a marketplace plan this year, which is more than double what it was — roughly 30,000 — in 2014, according to Kaiser's data.

Kaiser uses numerous federal sources, and its figures represent the number of people who selected or were automatically re-enrolled in a marketplace plan at the end of the open enrollment period.

Data from the state insurance division also shows marketplace enrollment has increased on a steady curve over the past decade, but that total enrollment peaked in 2015 and 2016 and has not yet returned to those levels.

The state records its enrollment data at a different point on the calendar, after some individuals who originally signed up for plans dropped them — perhaps because they later received employer-based insurance, became eligible for Medicare or were dropped from their plans, a state spokesman said.

"The numbers are good. We're really glad that these plans are available to people," Ommen said.

Ommen, however, pointed to state data that shows 90 percent of Iowans who select a marketplace plan receive what he called "significant" monthly subsidies.

"The reality is that the rates that people experience are not reflective of the actual costs associated with claims that are in those pools," Ommen said.

Ommen said he believes many of the marketplace plans seem tailored for older individuals and do not appeal to younger, healthier people whose presence could help stabilize the cost of marketplace plans.

Any Iowans who are considering a new marketplace plan should visit healthcare.gov to start researching plans as soon as possible, Ommen said. He also recommended speaking to an insurance provider.

"Getting engaged early is really important so people can better evaluate their circumstances and what works for their family," Ommen said.

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