2018 MIDTERM ELECTION

Time: D H M S

Iowa: 2 new companies are joining the exchange next year, but another one is seeking a 28% hike (UPDATE)

There's good news and bad news out of Iowa tonight. For 2015, there were originally only 2 insurance companies to choose from on Healthcare.gov: Coventry and CoOportunity. Unfortunately, the latter of these went belly-up for a variety of reasons, leaving Coventry the sole provider available on the exchange.

For 2016, it appears that 2 new companies (UnitedHealthcare and an unnamed one) will be jumping in to provide some competition:

Moderate-income Iowans who want to use Affordable Care Act subsidies to purchase health insurance will still not be able to choose policies from Wellmark Blue Cross & Blue Shield next year, but they should be offered policies from at least two competitors.

UnitedHealthcare, the nation's largest health-insurer, confirmed Monday evening that it plans to start selling policies to Iowans this fall on the online public marketplace, known as healthcare.gov. Coventry Health Care, which this year is most Iowans' sole choice on the system, said it plans to continue marketing plans on the public marketplace. The online system, also known as an exchange, is the only place where Americans can buy policies that qualify for the Obamacare subsidies.

The addition of UnitedHealthcare would mean that Iowans who want subsidized insurance would have at least two companies' plans to choose from. That allows consumers to compare prices, benefits and the networks of doctors and hospitals enrolled in each plan.

Insurance Commissioner Nick Gerhart said he expects a third, unidentified company to file an application this week to sell policies to Iowans on the exchange. "It's good news. People are going to have some choices," he said.

The bad news is that the largest insurer in the state, WellMark (Blue Cross Blue Shield) will not be on the exchange for a 3rd year; this is significant for several reasons. However, they hold around 30,000 off-exchange QHPs...and they're asking for a 28% rate hike (ouch). The article specifies that this is only for ACA-compliant policies, not Grandfathered (unknown number) or Transitional (around 110,000):

Jackson also disclosed Monday that her company is seeking to raise premiums by an average of 28 percent for about 30,000 individual customers who bought Wellmark policies since the Affordable Care Act took full effect in 2014. She said her company lost money on that group of customers, mainly because they used more health care, including prescription medications, than expected.

The two new entries obviously don't have any prior numbers to compare their 2016 rates with. Unfortunately the article doesn't say what Coventry's rate request is for next year, so I can't provide an average (either weighted or not). However, I can at least set the numbers up for now:

  • As of 2/22/15, Iowa had 45,162 QHP selections
  • 88% of that is around 39,700 people; call it 39K even to be safe
  • Coventry was the only company on the exchange (the CoOportunity enrollees were dumped on them or elsewhere), so they have all 39K
  • Off-exchange (WellMark) enrollees make up 30,000 QHPs.
  • The article makes no mention of any other off-exchange insurance companies offering ACA-compliant policies; for now I'll assume that this is pretty much it.

That means that a company making up 43.5% of the risk pool is seeking a 28% rate hike. Unless Coventry is keeping prices the same or reducing their rates, that suggests that the minimum requested rate hike for ACA policies in Iowa next year is at least 12.2%.

However, again, without knowing what Coventry's plans are (or whether there's other data missing), I'm not making that call just yet.

UPDATE: The third "mystery" company joining the exchange in Iowa is "Medica"