Aetna will not sell 2018 Obamacare exchange plans in Iowa

Justin Greene
April 8, 2017

"We need Congress to act", said Nick Gerhart, chief administrative officer at FBL Financial. The state's two largest exchange insurers cited the lack of market clarity for the decision. If Medica calls it quits, many Iowans will have no insurance options comes 2018.

"We are very concerned about this development, but Iowa is not alone as Affordable Care Act markets around the country are being left with few to no options available to consumers", Iowa Insurance Commissioner Doug Ommen said in a statement after the Wellmark departure was announced.

Aetna-based marketplace plans covered almost 30,000 Iowans before the decision to leave the marketplace. "Wellmark accounted for most of the plans sold in the state that comply with Obamacare but are not sold on Healthcare.gov". Aetna did not disclose its state-specific exchange membership, but now insures roughly 240,000 people on the exchanges in four states.

Iowa residents will now have to choose from just two payers that will continue to offer coverage through the ACA health insurance exchange.


The Nebraska Department of Insurance said that it had no information about changes among the state's insurers and that it was monitoring developments. Medica has until mid-June to decide if it will sell plans in 2018.

Across all four companies selling on the exchange in Iowa, there were 51,573 enrolled for 2017, according to government data. Aetna pulled out of most of the markets where it sold exchange plans past year, and its chief executive has described the marketplace as in a "death spiral". Given the minor loss, it is likely that Wellmark's exit has more to do with the uncertainty surrounding the future of the health insurance landscape and the prospect of further financial losses if the Trump administration fails to shore up the marketplaces, experts said. Wellmark's exit affects about 21,400 people-a little more than 1% of the insurer's membership in Iowa. The company now has 14,000 Iowa members.

The mandate is seen as necessary to get younger, healthier customers into insurance pools. Gundersen is a minor presence on the state's exchange.

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