Iowa officials said Friday they believe the stopgap proposal to revamp the state's individual insurance market still is being considered, even though The Washington Post reported that President Donald Trump personally sent word that it should be rejected.

The Post report, which cited individuals it did not identify, said the president read a newspaper article about Iowa's request in late August, then called Seema Verma, administrator of the Centers for Medicare & Medicaid Services and made it clear the state was to be denied.

The state submitted its formal proposal in August, and last month CMS certified the application was complete, a step that Iowa's insurance division portrayed as a positive sign.

Asked about the Post story Friday, an insurance division official said that it is their belief the proposal still is under consideration. Also, a spokesman for Sen. Chuck Grassley, R-Iowa, said Friday, "every indication, including Sen. Grassley’s engagement with state officials and the Administration, is that CMS is seriously considering the waiver."

The Post article was about Trump administration actions that advocates say are aimed at suppressing the number of people who will sign up for coverage under the Affordable Care Act when enrollment begins Nov. 1.

The administration has cut funding for organizations that help people enroll, including in Iowa. There also is continuing uncertainty over whether funding to help low- to moderate-income people with out of pocket costs will be approved.

Iowa's proposal, which is envisioned as temporary, was drafted after insurers began notifying the state it would not participate in the marketplace in 2018, raising the prospect that Iowans would be without options for coverage in the individual market. Minnesota-based Medica subsequently said it would take part, but at an average premium increase of 56 percent over 2017.

Iowa Insurance Commissioner Doug Ommen has argued that without the stopgap proposal, 20,000 Iowans would go without insurance or leave the state.

The proposal, if approved, would create a standard plan each insurer would offer and use federal funds to restructure premium tax credits and create a reinsurance pool to help pay for high cost customers. State officials have said that Wellmark Blue Cross and Blue Shield, the state's dominant insurer, would re-enter the market if the plan is approved.

Ommen has previously said he is in regular communication with CMS and that he expects approval by Nov. 1.

Some analysts have questioned whether the state's stopgap proposal qualifies for a waiver under the Affordable Care Act's requirements that changes meet guidelines to assure insurance still is affordable and available. But the state has said that its plan meets those standards. The proposal is in the midst of a 30-day comment period, which ends on Oct. 19.

Contact Ed Tibbetts at


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