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Hot on the heels of the news that the Trump administration 'mysteriously' failed to approve Oklahoma's plan to improve its marketplace (despite their approach having been previously blessed by HHS officials), comes more not-shocking news.
Iowa, which got a lot of press earlier this year for having one of the roughest situations in the country, had its own plan shot down by Trump himself.
There are legitimate questions about whether's Iowa's 1332 proposal met the terms imposed on such requests by the ACA (e.g., that it has to cover at least as many people as the ACA and provide at least as much financial protection for low-income people) but somehow I imagine adherence to the ACA's vision wasn't the primary motivation behind Trump's extraordinary intervention.
Iowa, which got a lot of press earlier this year for having one of the roughest situations in the country, had its own plan shot down by Trump himself.
For months, officials in Republican-controlled Iowa had sought federal permission to revitalize their ailing health-insurance marketplace. Then President Trump read about the request in a newspaper story and called the federal director weighing the application.
Trump's message was clear, according to individuals who spoke on the condition of anonymity to discuss private conversations: Tell Iowa no.
Iowa's aim was to foster more competition and better prices. The story said other states hoping to stabilize their situations were watching closely.
Trump first tried to reach Price, the individual recounted, but the secretary was traveling in Asia and unavailable. The president then called Seema Verma, administrator of the Centers for Medicare and Medicaid Services, the agency charged with authorizing or rejecting Section 1332 applications. CMS had been working closely with Iowa as it fine-tuned its submission.
State Insurance Commissioner Doug Ommen has repeatedly described the "Iowa Stopgap Measure" as critical to expanding marketplace options there. The plan would abolish the ACA exchange there and convert consumer subsidies into a type of GOP-styled tax credit. New financial buffers would help insurers handle customers with particularly high medical expenses.
Without the measure, "over 20,000 middle class farmers, early retirees and self-employed Iowans will likely either go uninsured or leave Iowa," Ommen warned in a Sept. 19 statement. Those who sign up for 2018 exchange coverage face premium rate increases of 57 percent on average from the single insurer participating.
There are legitimate questions about whether's Iowa's 1332 proposal met the terms imposed on such requests by the ACA (e.g., that it has to cover at least as many people as the ACA and provide at least as much financial protection for low-income people) but somehow I imagine adherence to the ACA's vision wasn't the primary motivation behind Trump's extraordinary intervention.
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