Health Care

Iowa to sell health plans that can disqualify people based on pre-existing conditions

New health plans sold through Iowa’s Farm Bureau will be able to ask applicants if they have any pre-existing conditions.

According to a checklist posted online by the Farm Bureau, applicants will be asked about a list of conditions related to mental health, blood pressure, reproductive system, lungs or the respiratory system, among others.

In an interview with the Des Moines Register, Farm Bureau Vice President Steve Kammeyer said some applicants for the new coverage could be turned away or face higher premiums if they have pre-existing health issues. He could not say which conditions would trigger those actions.

According to the checklist, if an applicant says they have been treated for any of the 16 conditions in the past five years, they will be required to provide detailed explanations of the treatments, medications and current status.

The plans were made legal under a law signed by Iowa Gov. Kim Reynolds (R) in April that allows the Iowa Farm Bureau to collaborate with Wellmark Blue Cross Blue Shield on self-funded “health benefit plans.”

To be eligible, applicants must be an Iowa Farm Bureau member living in the state, and not eligible for Medicare, Medicaid or an employer group health plan.

The plans, which will be available starting Nov. 1, are expected to be much cheaper than plans sold on the state’s ObamaCare exchange because they don’t have to meet federal requirements.

ObamaCare prohibits all individual and small group health plans — for people who don’t have coverage through an employer — from disqualifying people with pre-existing conditions, or charging them more money. It also requires the plans to offer 10 “essential health benefits,” including maternity care, mental health care and substance abuse treatment.

Wellmark said the new plans would cover maternity services, mental health care, addiction treatment and prescription drugs.

The Iowa law takes advantage of a loophole in ObamaCare by contending that the health benefit plans offered by the Farm Bureau and Wellmark are not actually health insurance plans. Since they are not technically insurance, they’re also not regulated by the Iowa Insurance Division.

Farm Bureau President Craig Hill in a statement said the health plans may appeal to Iowans who don’t qualify for ObamaCare subsidies.

Critics of ObamaCare say that law drives up costs and that allowing people to purchase plans that don’t meet the law’s requirements will provide more freedom of choice.

Iowa is also taking advantage of a situation only possible because congressional Republicans eliminated ObamaCare’s individual mandate penalty.

Because the Farm Bureau plans lack ObamaCare’s consumer protections, they would not count as insurance under the law. Anyone enrolled in those plans would be subject to ObamaCare’s financial penalty for not having insurance.

But enforcement of the mandate will end next year, and new rules from the Trump administration make it easier for insurers to offer less than the comprehensive coverage required by ObamaCare.


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