Medica weighs staying in Iowa's health exchange next year

Iowa's last health care insurer to sell policies to individuals statewide through the federal Affordable Care Act said Monday it needs to know more about how the state's insurance market will function next year before making a final promise to stay.

Minnesota-based Medica has preliminary plans to sell insurance in Iowa next year in the individual market and expects to make an announcement soon, spokesman Larry Bussey said.

Monday is the filing deadline for companies planning to participate in the Iowa market to file rate plans for 2018, but insurers have until September to make a final decision on whether to sell policies on the state's exchange.

Iowa last week applied for a federal waiver that would allow government subsidies designed to lower costs for low-income and older participants to be used to entice younger people to buy insurance. It was viewed as an effort to keep Medica in the Iowa market while luring others back.

"It is our intent to stay in Iowa, but we can't make a final decision until we have clarity on the rules for the market," Medica spokesman Larry Bussey said. "We went into Iowa with the intention of staying for the long term. There are a lot of people — farmers, small business owners and others — who are dependent on a thriving individual market. We want to contribute to making it work."

Thousands of young, healthier people have fled the Iowa market as insurance rates increased, leaving a higher number of older, sicker people in a smaller individual market pool. That drove up costs and caused insurance companies to lose millions of dollars, Iowa Insurance Commissioner Doug Ommen said.

He added it's unlikely Congress will make any changes to the ACA in time to keep Iowa's individual health insurance market from total collapse, leaving nearly 72,000 people with no options to purchase insurance next year.

Medica is the only company offering coverage across Iowa that hasn't announced that it will stop selling health insurance on the ACA exchange next year.

During the first week of April, Wellmark Blue Cross & Blue Shield and Aetna announced they were pulling out of the Iowa market after this year. That followed the announcement of withdrawal of United Healthcare in April 2016 and the failure in early 2015 of an insurance cooperative, CoOportunity, that had been set up by the ACA law.

Wellmark recently said it would consider selling insurance in Iowa next year if the government approves the Iowa waiver request.