Editorial: Optimism about Iowa's insurance exchange


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It’s been more than three years since the Affordable Care Act, now known by both proponents and detractors as Obamacare, was signed into law. Yet the effects of this overhaul of health-care insurance have thus far been mostly limited to hypotheticals.

But on Oct. 1, a major milestone in the act’s infrastructure will come to pass as electronic health-care exchanges across the country come online, allowing Americans to browse and eventually purchase varying levels of policies (from bronze to platinum), based on their share of monthly premiums and out-of-pocket costs.

Essentially, these different plans depend on how one uses health insurance. Those who visit the doctor a lot should choose gold or platinum plans to reduce their contribution at the doctor’s office at the expense of higher monthly premiums and vice versa with bronze and silver plans.

Low-income Americans will also be able to buy health insurance on these exchanges with the help of a federal subsidy.

Lawmakers on both sides of the aisle have said Obamacare will change the way that businesses and individuals purchase health insurance; whether the changes will come as a boon or bane has yet to be seen.

Iowans at least don’t have to worry about one aspect of care: increased cost.

The state’s insurance commissioner, Nick Gerhart, said on Sept. 12 that Iowans’ rates under the new system would “continue to compare very favorably” to other states in the electronic system. In fact, Iowa’s costs beat out most others, with only two of 17 states listed in a recent national report showing lower rates.

However, the selection of health-insurance providers may not be as great as originally championed by proponents of Obamacare. CoOpportunity Health, a new provider aimed mostly at individuals, is one of two of major providers on the electronic exchange, the other being insurance giant Coventry. Other Iowan providers such as Wellmark Blue Cross & Blue Shield plan to enter the market several years down the road.

These providers will sell directly to individuals, a deviation from the norm of employers paying for and choosing health-care insurance providers. Several other regional insurance companies will still sell to smaller employers, but by and large, the new system represents a major change for Iowans.

In order to use the electronic health-insurance marketplace effectively, Iowans should take an active interest in their health care and make sure to select a plan (and a provider) that works best for them.

Iowa as a state will also have to carefully manage the operation of the new system. As the economy is still slow in recovery, unexpected changes and confusing aspects of the marketplace could have a devastating effect on unemployment and smaller employers struggling to adapt to the new requirements of the Affordable Care Act.

In order to maintain low costs in the long-term by keeping participation high, the state will also have to ensure that the insurance exchange is well-publicized and relatively easy to use.

Even though some lawmakers are still trying to block parts of Obamacare, the time has come for individuals to come to terms with the law, for better or for worse. Becoming well-versed in what you and your family need from the system is essential to making sure those lower costs stay low when coverage from the system begins early next year.

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