No waiver for Healthy Iowa Plan yet; Iowans can still sign up starting Oct. 1

DES MOINES - Gov. Terry Branstad said Iowans can sign up for the Healthy Iowa Plan Tuesday even though the federal government hasn't yet given the state the authority to run it.

The plan is the state-run alternative to the federal Affordable Care Act, and the state must obtain a waiver in order to run the program.

Meanwhile, Tuesday is the day federal law says people across the country can begin signing up for insurance plans on their state-run exchanges. To do this, individuals should start by logging on to the healthcare.gov website.

“We're going to continue to go forward on the assumption that the Department of Health and Human Services is going to approve this,” Branstad said. “We've been working with them since February, and they recently approved a similar waiver for the state of Arkansas, and they've done so for Indiana. We see no reason why they shouldn't do the same for the state of Iowa.”

Branstad met last week with federal officials, who haven't signed off completely on Iowa's plan. One sticking point appears to be the requirement that some individuals below 100 percent poverty - or roughly $23,500 annually for a family of four - would have to pay some premium for health coverage.

Speaking with reporters Monday, the governor stressed the Healthy Iowa Plan allows for reduced and waived premiums if people can prove they've adopted preventative health measures, such as quit smoking.

Mary Nelle Trefz, a policy associate with the Child & Family Policy Center, said Iowa not having its waiver so far probably “won't have much of an effect” on the program.

“They've been working on this for a while,” she said. She also stressed that although Tuesday is the first day for sign up, people don't all have to rush onto the website at once nor do they have to make choices right away.

“The plans don't go into effect until Jan. 1,” she said. “People have a few months still - probably until December 15th - to sign up and still be enrolled for the January 1 roll out.”

For now, the Branstad administration struck an optimistic tone.

“We'd like it to be approved as soon as possible. Obviously, we're beginning enrollment of Iowans (Tuesday),” said Michael Bousselot, Branstad's health policy adviser. “That being said, as the year goes on we'll continually evaluate when need to have that waiver approved by.”

He added that if Dec. 1 passes without a waiver, the Branstad team would have to “re-evaluate” its position.