DES MOINES - Iowans should soon know more about what they can expect to find on the new health exchange, though whether the state's two largest carriers will participate remains unclear.
Sunday is the deadline for insurance carriers to file to be included in the online insurance marketplace for Iowa, said Iowa Insurance Commissioner Nick Gerhart. He expects to release the insurance providers' names on Monday, though the details on the specific plan proposals will come later.
Representatives for Wellmark Blue Cross and Blue Shield and UnitedHealthcare - which combined hold roughly 90 percent of the Iowa insurance market - declined to comment on their intentions.
"We don't have a clear picture of who's going to be in or not," said Gerhart, who said he had commitments from a few carriers. "But whether or not our two largest are going to be in it, we don't know."
Under President Barack Obama's health care overhaul, all states must have a health exchange, with enrollment starting Oct. 1, and coverage on Jan. 1. Iowa is partnering with the federal government for the online exchange, where customers will be able to shop for coverage and qualify for subsidies and benefits.
According to a recent White House memo, Iowa is one of 29 states where one insurer covers more than 50 percent of the marketplace. The memo argued that the exchanges would increase health care competition in states like Iowa, by providing more choices.
But in some other states, major insurance carriers have opted out of the exchanges or limited the coverage that is available. In Mississippi, for example, the insurance commissioner has said that the private insurers plan to offer exchange coverage in only 46 of the 82 counties. In Minnesota, three carriers have already opted out of portions of the marketplace, including UnitedHealth Group, the company that includes UnitedHealthcare.
So far, the only declared insurer that will participate in Iowa is the new CoOportunity Health, a federally funded nonprofit established to provide health care in Iowa and Nebraska. Chief Executive Officer David Lyons said he expects to offer a range of different plans.
"We will offer what I think will be the widest range of options," Lyons said. "We're not sure who else will be on the exchange, but we're confident there will be several statewide players."
Sarah Lueck, Senior Policy Analyst for the Washington-based Center on Budget and Policy Priorities, said some insurance companies may want to sit out the first year of the new law.
"From what I've seen, and hearing what insurers have been saying, they want to take a wait-and-see approach. They want to see what the market looks like," said Lueck.
Gerhart said if the two main carriers opted out, the exchange plans may be coming from untested insurance companies. But he said any plan offered will have to meet coverage standards set by the health care law.
"I would have no problem buying those products for my family. They have to provide all the essential health benefits," Gerhart said.
Gov. Terry Branstad's spokesman Tim Albrecht said the governor expects a "robust offering of coverage options, including multiple statewide plans."