Affordable Care Act/Obamacare

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Enrollment in the Affordable Care Act is open through December 15 of this year.

"There's lots of mixed messaging and we don't have the advertising dollars to set the record straight," says Nicole Kock, a health insurance navigator with Visiting Nurse Services of Iowa. But, she adds, "The marketplace is here. We've got an insurer that's committed to Iowans for 2018."

John Pemble/IPR

Governor Kim Reynolds has been in office for five months.  In the first half of this River to River program, host Ben Kieffer asks Reynolds about health care, opioid abuse, partisan politics, and the upcoming legislative session.

To start, Reynolds says she had a number of topics to offer Iowa's congressional delegation. 

She says that she thanked them for support of the Renewable Fuel Standard, and work on healthcare.  Her priorities for next legislative session are getting a water quality bill and having a competitive bushiness environment.

John Pemble/IPR

Iowa's U.S. Senator Joni Ernst says she’s hopeful lawmakers will pass legislation she says will help people facing steep premium increases for individual health insurance policies under the Affordable Care Act.

About 72-thousand people in Iowa face increases of nearly 60% after the state withdrew its proposal for a stopgap plan that would have provided relief. In this interview with River to River host Ben Kieffer, Ernst says the current situation puts a lot of Iowans in a bind.

Joyce Russell/IPR

A plan that officials had hoped would keep health insurance affordable for thousands of Iowans has been withdrawn, clearing the way for premiums to more than double.    

Governor Reynolds' administration had been urging the federal government to approve its so-called stopgap plan.  

The plan would have restructured benefits for Iowans getting individual insurance under the Affordable Care Act in order to draw in more young healthy people to keep premiums down.  

doctors office
Jennifer Morrow / flickr

Navigators are getting ready to sign Iowans up for Obamacare next month despite uncertainty surrounding the health care law. They are preparing for the regular enrollment period as state and federal lawmakers continue to push for changes to the Affordable Care Act.

Karen Sullivan of Visiting Nurse Services manages a program in central Iowa that helps people sign up for insurance through the ACA. She says navigators are still scheduling appointments for November. 

Ben Terrett

Senate Minority Leader Chuck Schumer says it is difficult to govern with what he calls a president "zigging and zagging" on his support of bipartisan efforts to make changes to the Affordable Care Act. In this politics Wednesday edition of River to River, host Ben Kieffer is joined by professor of political science at Iowa State University, Jim McCormick.

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It’s less than two weeks until people have to start signing up for next year’s health insurance plans, and Iowans who buy their own insurance through the Affordable Care Act don’t know what to expect. They don’t know what system they will use to buy insurance, what plans will be available to them, or how much they will have to pay.

Iowa is waiting for a last-minute decision from federal agencies on whether Iowans will buy insurance through the ACA marketplace, or through the state’s proposed "stopgap" system.

Sarah Boden/IPR

Gov. Kim Reynolds says she hasn’t received any indication from the White House that it opposes Iowa’s attempt to lower premium rates for health insurance policies on the Obamacare exchange.

doctors office
Jennifer Morrow / flickr

Organizations that help Iowans sign up for health insurance through the Affordable Care Act are dealing with new funding cuts.

Late Wednesday night, the U.S. Department of Health and Human Services announced various grant reductions for ACA navigators. Some cuts are as high as 90 percent.

Genesis Health in the Quad Cities is facing a 90 percent cut to is ACA navigator grant.

doug ommen
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Iowa’s insurance commissioner says he is now "less optimistic" about winning federal approval for a plan to stabilize the state’s individual health insurance market.

The state of Iowa submitted a "stopgap" plan to federal agencies in August. It would change the distribution of insurance subsidies under the Affordable Care Act.

Insurance Commissioner Doug Ommen told lawmakers Tuesday he was hoping to know by now whether the plan would be approved.

doug ommen
Iowa Insurance Division

Iowa has submitted a "stopgap" plan to the federal government with the goal of stabilizing the state’s collapsing individual health insurance market.

The plan redirects federal subsidies under the Affordable Care Act to encourage younger, healthier people to buy insurance.

Iowa Insurance Commissioner Doug Ommen says the plan to change parts of the ACA will prevent thousands from dropping insurance. 

joni ernst
Katarina Sostaric / IPR

Sen. Joni Ernst says she wants the federal government to continue making payments for Obamacare subsidies to health insurance companies.

President Trump has repeatedly threatened to stop making "cost-sharing reduction" payments.

That uncertainty has led the only health insurance company left on Iowa’s exchange to propose a nearly 57 percent rate hike for 2018. Medica originally requested a 43 percent increase. 

joni ernst
Katarina Sostaric / IPR

At a town hall Tuesday in Washington, Iowa, Sen. Joni Ernst took several questions about the so-far unsuccessful Republican efforts to repeal and replace the Affordable Care Act.

Some questioners asked Sen. Ernst to support "Medicare for all," while others said they want no government involvement in health insurance.

Ernst says bipartisan groups of lawmakers are working on healthcare solutions after "repeal and replace" legislation failed several times in the Senate this year.

doctors office
Jennifer Morrow / flickr

The Iowa Insurance Division is getting close to finalizing its "stopgap" plan to prop up the state’s individual health insurance market under the Affordable Care Act.

An independent economic analysis shows more Iowans will be able to keep their individual ACA health insurance if the federal government approves the state’s stopgap plan.

pills and money
Images Money / flickr

Iowans who buy individual health insurance on the state’s Affordable Care Act exchange could see even higher premiums next year if President Donald Trump stops funding subsidies that lower the coverage costs for some patients.

The president has been threatening to stop making cost sharing reduction (CSR) paymentss He may make a decision on CSR this week. 

Medica, the only company still on Iowa’s exchange for 2018, says it will raise premiums if President Trump cuts that funding.

AMY MAYER/IPR FILE PHOTO

Sen. Chuck Grassley says he plans to vote “Yes” on a motion to proceed with debate on a bill that repeals the Affordable Care Act. If it passes, this vote won’t repeal Obamacare, but it is a key procedural step towards what has been the goal of Republican senators for the past seven years.

Grassley says voting to proceed allows for a more inclusive process.

AMY MAYER/IPR FILE PHOTO

Sen. Chuck Grassley says he hasn’t decided whether he’ll vote for or against a healthcare bill that would allow insurance companies to limit what they’d pay for certain services.

The Senate Obamacare repeal bill proposes allowing states to redefine which services insurance companies are required to cover. The concern is this could result in dollar limits for things like hospitalizations or prescription drugs.

Grassley says senators are still submitting amendments, so he’s not ready to take a position until he’s seen the final bill.

Sarah Boden / Iowa Public Radio

Sen. Joni Ernst held a town hall meeting in Harlan before heading back to Washington from the July 4 recess. Most of the questions she fielded focused on the Senate Republican plan to repeal the Affordable Care Act.

Senate Majority Leader Mitch McConnell has said if the slim Republican majority can’t come together, a bipartisan solution might be next. Some of the town hall's attendees favored compromise.

But while speaking with reporters, Ernst didn’t seem receptive to that idea quite yet.

Flickr / William Patrick Butler

Sen. Chuck Grassley says he probably won’t support an amendment by Texas Sen. Ted Cruz to the Senate’s Obamacare repeal bill.  Cruz proposes allowing insurance companies to sell two types of healthcare policies, one that is compliant with the Affordable Care Act and one that is not.

Grassley says he’s concerned how Cruz's amendment might affect people with pre-existing conditions. 

FLICKR / JENNIFER MORROW

People in 94 of Iowa’s 99 counties may have no options in 2018 for buying individual healthcare polices on the state's insurance exchange that was created under the Affordable Care Act. 

Currently nearly 48,000 people have insurance through Iowa's ACA exchange. But recently two of the three insurers providing individual plans announced they were leaving the Iowa market next year.

That left Minnesota-based Medica to be the exchange's likely sole participant. Now Medica is saying that it too may be leaving the state.

The Iowa Hospital Association says it’s important not to lose the gains made under the Affordable Care Act. The warning comes after the insurance carriers Aetna and Wellmark announced this week that in 2018, they’ll stop selling individual policies on Iowa’s healthcare exchange created under the ACA.

Iowa will soon have only two insurance carriers providing individual healthcare policies. Connecticut-based Aetna has become the second company this week to announce it will stop selling insurance policies on Iowa’s public exchange in January 2018.

Earlier this week the Iowa Insurance Commission announced that Wellmark would also no longer provide individual plans in Iowa. Wellmark says rising costs are causing its departure. Aetna cites financial risk and an uncertain market outlook for its decision to exit.

AMY MAYER/IPR FILE PHOTO

Sen. Chuck Grassley says the replacement bill for the Affordable Care Act by House Republicans will have to be rewritten. Yesterday the non-partisan Congressional Budget Office released a report that found some 24 million people who currently have health insurance would not be covered by 2026 under the GOP proposal. 

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Iowa’s only Democrat in the U.S. House of Representatives says he still doesn’t know the details of what Republicans will propose as a replacement for the Affordable Care Act.  Dave Loebsack is on the House Energy and Commerce Committee, which will vote on a replacement before sending it to the full House.

“So far what I have heard is that what they have offered is wholly inadequate and it doesn’t deal with the problems that we tried to deal with in the Obamacare legislation,” he says.

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A repeal of the Affordable Care Act could leave more than 230,000 Iowans, including 25,000 children under the age of 18, without health coverage. That’s according to the Iowa Policy Project. Peter Fisher is research director for the IPP. He says there are two ways the ACA expanded access to care in Iowa.

“About 70,000 people were covered by the Medicaid expansion, and another 47,000 received subsidies for their insurance when they purchased insurance on the exchange. So there are two ways that the ACA insured substantially more Iowans than were previously insured,” he explains.

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Iowa’s Insurance Commissioner Nick Gerhart is stepping down on the 23rd of this month. He’s served as state insurance commissioner since February 2013, overseeing the state’s Medicaid transition, as well as the implementation of the Affordable Care Act. During this River to River interview, he talks with host Ben Kieffer. 

Gerhart says that policy makers need to step back and take a look at the entire healthcare ecosystem, not just the insurance piece. 

Gage Skidmore

On this politics day edition of River to River, Ben Kieffer talks with political analysts, Tim Hagle and Justin Holmes, about President-Elect Donald Trump’s latest cabinet picks and what the current appointees may plan to do if approved by the Senate.

Trump most recently nominated Georgia Rep. Tom Price as secretary of Health and Human Services. Price has been a consistent opponent of the Affordable Care Act in Congress, and he’s developed an alternative plan to replace the ACA.

Hagle doesn't expect the popular aspects of the ACA to be abolished.

julep67 / Flickr

Tuesday marked the first day of open enrollment for Obamacare health insurance. It comes just a week after the Department of Health and Human Services announced the prices of policies sold on the exchanges would rise an average 22 percent for 2017.  Pete Damiano, Director of the Public Policy Center and of the Health Policy Research Program at the University of Iowa, says that number may be scarier in theory than it is in reality.

One year ago Iowans and Nebraskans enrolled in the healthcare startup Co-Opportunity Health found out they were losing their healthcare coverage. There are 11 other of these so-called “co-ops” that were funded by the federal government that have failed. 

The Affordable Care Act had set aside funding for these so-called health co-ops.

They enabled organizations to compete in places where there weren’t many insurers.

A year ago, Iowans enrolled in the healthcare startup Co-Opportunity found out they were losing their healthcare coverage. Since then a dozen of these so-called “co-ops” that were funded by the federal government have failed.

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