DES MOINES — Iowa’s statewide farm organization thinks it has a plan to help farmers who are struggling to find affordable health insurance.
Supporters say the plan, which is under consideration by lawmakers, is a creative and innovative solution for those who cannot afford health insurance plans but earn too much to qualify for financial assistance.
But there are concerns, raised by some lawmakers and an insurance company not involved in the proposal, that the legislation clears the plan of insurance regulations and could add stress to the already unstable federal health insurance marketplace.
Under the proposal, Wellmark Blue Cross and Blue Shield — the state’s largest health insurer — would create health benefit plans for Iowa Farm Bureau members. The plans — they cannot be called insurance — would be designed to be affordable for lower-income farmers. The legislation makes that possible by stating the plans are not subject to state or federal insurance regulations.
So the plans could be tailored to an individual farmer’s needs, and not include the base coverage requirements for an insurance plan to be legal under the federal health care law known as the Affordable Care Act.
Without a requirement that the plans meet those bench marks, they could be cheaper.
Tens of thousands of Farm Bureau members could be eligible for the plans, bureau President Craig Hill said.
The Farm Bureau thinks the proposal would help its members in the federal health insurance marketplace’s no man’s land — individuals who make too much income to qualify for financial assistance but who do not make enough to cover the cost of health insurance.
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“Many producers, many farmers, either the husband or the spouse are looking for off-farm employment” to obtain affordable health insurance, Hill said. “It takes them off the farm. So yeah, we are quite motivated.”
Most of the lobbying groups registered on the legislative proposal say they are undecided; the only groups registered in support are the Farm Bureau and Wellmark.
The state insurance oversight department is registered neutral on the proposal, but a spokesman credited Farm Bureau and Wellmark for devising a plan to help Iowans struggling to afford health insurance.
“The plan put forth by Farm Bureau can provide relief and serve a need for Farm Bureau members being forced to deal with astonishingly high premiums,” said Chance McElhaney, a spokesman for the Iowa Insurance Division, in an email. “Farm Bureau has been providing benefits of many sorts to its membership to support Iowa’s agriculture industry for 100 years now and we appreciate it working to help its members at a time when the ACA has left them without any real options to protect themselves, their families or their livelihoods.”
McElhaney also noted the benefits plans would not be considered insurance and fall outside state regulation, and said the insurance division also continues to implore federal lawmakers to create a permanent solution to issues with the health insurance marketplace.
That lack of regulation concerns Geoff Bartsh, the vice president and general manager of individual and family business for Medica, a Minnesota-based health insurance company that sells plans in Iowa, including on the federal marketplace.
Medica is the only company offering health insurance plans on the federal market until next year, when Wellmark plans to also sell them.
Bartsh said the proposal could allow Farm Bureau and Wellmark to cherry-pick healthier customers, pushing sicker individuals — and thus people more expensive to cover — into the marketplace where only Medica resides.
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“I certainly understand why Farm Bureau is trying to find a solution for their members who don’t receive a subsidy and are struggling to afford insurance in the individual market. I think there is a big issue in terms of the affordability of insurance, and I certainly understand why they’re trying to find different ways to provide an affordable option for their members,” Bartsh said.
“That said, we have some fundamental issues with exempting them from any and all insurance regulations as a policy and what that might mean for the market.”
Bartsh also said Medica finds it unfair that the legislation singles out Wellmark as the company to create the benefit plans for Farm Bureau.
Medica is one of three lobbying organizations registered as opposing the proposed legislation; the others are the Child and Family Policy Center and the American Cancer Society.
Officials from Wellmark and the Farm Bureau said they developed the partnership because they have worked together for decades on other benefits plans.
And Hill said the lack of regulation does not worry him because, he said, Wellmark is a reputable institution.
“I’ll tell you we have a reputation that we value, and we value the benefits and services that we provide our members. Wellmark does as well. I think the reputation of these two entities combined says a lot,” Hill said. “We wouldn’t do anything to blemish our brand or our reputation, so hopefully that will be meaningful to lawmakers.”
The proposal is on the Iowa House’s debate schedule for Monday, meaning state lawmakers in the House may debate and vote on the bill then. Before becoming law, it also would have to be approved by the Senate and governor.