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This week, Iowa senators approved controversial legislation that would make certain health plans exempt from Affordable Care Act mandates. If signed into law, the bill would have a significant impact on the way many Iowans receive health coverage.

The legislation, approved in a 37-11 vote, combines two proposals that would do the following:

  • Allow the Iowa Farm Bureau Federation to partner with Wellmark Blue Cross/Blue Shield to offer an association health plan to qualifying participants
  • Allow multiple small businesses to band together to provide health coverage for their employees under plans that would not be regulated by the state insurance commissioner or subject to ACA rules and regulations.

The measure was passed by the Iowa House last week, and will now go to Gov. Kim Reynolds who, according to a spokeswoman, is “eager” to sign it.

Proponents say the bill aims to reduce costs and help people who currently buy individual policies or who do not have any coverage. However, critics worry about consumer protections as the bill also allows insurers to deny coverage based on pre-existing conditions, limits coverage by not paying for certain types of care, and sets up lifetime caps for benefits.

Medica, a competitor of Wellmark, is a strong critic of the bill, saying it would unfairly let Wellmark “cherry pick” health customers, leaving them with a more expensive pool of customers to ensure. Medica is considering challenging the proposal in court.

Wellmark is not selling individual plans that comply with the ACA currently, leaving Medica as the sole carrier for that market. However, Wellmark recently announced that it intends to re-enter the market in 2019.

Iowa’s current insurance commissioner, Doug Ommen, has expressed support for the Wellmark/Farm Bureau proposal, saying it’s a temporary way to help more than 20,000 Iowans who are struggling to pay for health policies.

The Senate had previously passed each component of the bill separately, but the bills needed to be combined and approved before the governor could sign off. The now complete and approved bill is on its way to Gov. Reynold’s desk for her expected signature.



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