Iowa's health insurance commissioner is proposing that the federal government pay millions of dollars to help shore up its Obamacare exchange, which is facing the prospect of having few insurers participate next year.
Among Iowa's request is $80 million from the federal government to help pay for a reinsurance program that helps compensate insurers for costly care. The state has one patient whose care costs $1 million a month, and includes many unhealthy, expensive customers on the exchange.
The plan, put forth by commissioner Doug Ommen, would need to be approved and funded by the federal government. According to the Des Moines Register, Ommen and insurers met with Centers for Medicare and Medicaid Services administrator Seema Verma last week to review the proposal.
"This is not a perfect plan," Ommen told the Register "It's a stopgap."
In the face of massive financial losses, as well as uncertainty over the law's future, several insurers have said they are either planning to leave the exchange next year or are considering it.
Iowa's plan would also allow subsidies to be restructured so young adults would receive more funding assistance to help them purchase health insurance, and the income cutoff for those subsidies would increase. Under current law, most people who make more than roughly $48,000 a year do not qualify for premium assistance for individual health plans.
Instead of buying plans through healthcare.gov, the federal exchange that most states use, customers would purchase plans through independent agents or directly from the health insurance company. The state would then review whether people qualify for tax credits to pay for coverage.