Enrollment Open in Iowa for ACA Coverage

Nov 20, 2020

Open enrollment is now underway in Iowa for the Affordable Care Act health insurance - for new participants and anyone who might want to make changes in their current policies. It opened on November lst and continues through December 15th, and takes effect on January lst.

In Iowa about 50,000 people are currently enrolled in the ACA, and state Insurance Commissioner Doug Ommen believes it'll stay at about that level next year.

"And so as prices continued to go up from the original rollout back in 2014, the prices got higher and higher every year until it drove about 25,000 people out of the market. But since that time, since most of the folks who are still in the ACA market receive some benefit associated with a tax credit system, that market has now remained relatively stable."

He does not believe the pandemic will have much impact on ACA enrollment because price, the cost of policies, is the main factor people use to make decisions.

"But if people have been experiencing unemployment, they would actually qualify for Medicaid, and so this market is probably less related to the changes that might have been occurring due to the pandemic."

For enrollment, Iowa is divided into seven regions, with the Quad Cities included in region six, along with 13 other counties (Benton, Black Hawk, Buchanan, Cedar, Clayton, Clinton, Delaware, Dubuque, Iowa, Jackson, Johnson, Jones, and Linn). Premiums for someone who does not smoke will average about 530 dollars a month next year, with costs in the other regions ranging from 523 dollars up to 550 dollars per month.

And those costs are down as much as 100 dollars from this year.

Ommen says Iowa enrollees in the Affordable Care Act health insurance plans are mostly in one demographic group. 

"For people over 65 they're going to be in the Medicare system, but for folks that are under 65 we have a greater than normal participation by people that are middle aged. And so again that is related to the way the pricing structure works and it does drive higher costs."

And that's one of his main criticisms of the current system - changes are needed in how subsidies and tax credits are calculated for participants.

"They're currently income only and that does not recognize that younger populations, younger families, have lower risk and so that's how we ended up with more middle aged folks in it than is going to be appropriate in order to have an effective, actuarially- based insurance pool."

Ommen strongly advises people interested in enrolling to start now - go online and shop for a plan, don't wait until the last minute. The Iowa Insurance Division website has a lot of information (iid.iowa.gov), and help finding local insurance agents who can answer questions.


For 2021, Medica and Wellmark will offer ACA-compliant health insurance plans in all 99 counties, while a third company, Oscar, will only offer plans in 24 counties.