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When It Comes to the ACA in Iowa, There's "Money Left on the Table"

4 of 5 Iowans eligible for insurance plans through the exchange have not bought one.

Tuesday marked the first day of open enrollment for Obamacare health insurance. It comes just a week after the Department of Health and Human Services announced the prices of policies sold on the exchanges would rise an average 22 percent for 2017.  Pete Damiano, Director of the Public Policy Center and of the Health Policy Research Program at the University of Iowa, says that number may be scarier in theory than it is in reality.

"The way that this is sort of being talked about is as if the people who are uninsured and going to the exchanges or already have a health insurance policy through the exchange, that their costs are going to go up. And that's actually not true."

Damiano says that, like so many things when it comes to Obamacare, you have to look at the details.

"Yes, the average rates are going up, but the subsidy has also gone up to match. So across the country, and Iowa included, it's actually a net wash. So there's no increase for the people who are buying insurance policies through the exchange on average."

Iowa may not be taking full advantage of those subsidies, however. Damiano says that only 20% of Iowans eligible to buy a health insurance policy through the exchange have chosen to do so. According to the Kaiser Family Health Foundation, that's the lowest proportion of any state. If those figures are correct, two-hundred-thousand eligible Iowans aren't buying insurance policies, and the majority would have qualified for subsidies based on a lack of employer-offered plan and low income.

“That’s a lot of people who are leaving money on the table if you will, because probably two-thirds to three-fourths of those people were eligible for some sort of subsidy to purchase that health insurance and could get it at a reasonable price.”

The reasons why aren’t entirely clear but Damiano thinks part of it is a simple awareness issue.

“We haven’t marketed that opportunity very well in Iowa. You know, you don’t see ads, billboards, anything promoting the fact that you can get subsidized private health insurance. Again, this isn’t government insurance. We’ve done a pretty good job enrolling people into the Medicaid expansion, but on the private side, through the exchanges, we haven’t.”

In this hour of River to River, host Ben Kieffer talks with Damiano about the latest developments in healthcare access.

Also on this program:

  • Fred Jones, Professor of Sociology & Criminal Justice at Simpson College, sharing a remembrance of slain Urbandale Officer Justin Martin
  • Steve Foritano, retired Polk County prosecutor, sharing a remembrance of slain Des Moines Sergeant Anthony "Tony" Beminio
  • Kenneth Meyer, professor of public administration at Drake University, discussing scientific data on police officers killed in the line of duty
  • Lee Hermiston, reporter at The Gazette, on an officer-involved shooting of a Cedar Rapids man
  • Jim Brown, mayor of Cedar Falls, on flood recovery and the federal disaster proclamation


Ben Kieffer is the host of IPR's River to River