By Rod Boshart

Gov. Kim Reynolds signed legislation into law Monday that will provide a health benefit plan option -- one not subject to federal regulation or state oversight -- for farmers, small businesses and other Iowans who no longer can afford independent insurance coverage.

Reynolds reiterated her call for Congress and President Donald Trump to fix what she called Iowa's collapsing individual health insurance market. But she said that, in the interim, provisions of Senate File 2349 will provide an alternative by allowing health benefit plans created by multiple employers or Iowa Farm Bureau Federation to offer access to affordable health care for up to 26,000 uninsured Iowans.

The plans will not comply with the federal Affordable Care Act rules and will not be under the regulation of the Iowa Insurance Commissioner.

"Because of this bill, thousands of Iowans will now have affordable health care coverage," Reynolds told a group of legislators, Farm Bureau and insurance company representatives as well as Iowans who hope to enroll in new health benefit products likely available for 2019.

One of those Iowans, Rose Danaher, a beginning farmer from Iowa County near the Amana Colonies, said she lost her health insurance coverage last year and she cannot afford the high premiums and deductibles of the only insurance option now available to her.

"I don't mind paying more than my fair share to help stabilize the marketplace, but there's no reason that a healthy 32-year-old should be paying more health insurance than for her mortgage," Danaher said. "Between student loans, a mortgage and a fledgling farm business, these new rates just didn't pencil out."

The same was true for Josh Crist, who said he and his wife are self-employed small business owners with a small farm near Tipton. They can't afford health insurance coverage for them and their four daughters in the current market.

"As a family of six, we've been forced to make tough decisions," Crist said during Monday's bill-signing ceremony in the governor's Statehouse office.

"To me, the health benefits bill is a start in the right direction for health care premiums that have increased dramatically in the last several years. Our out-of-pocket health care costs are now combined to nearly $24,000 per year."

The legislation Reynolds signed will alow the Iowa Farm Bureau Federation to partner with Des Moines-based Wellmark Blue Cross and Blue Shield to offer an association health plan to qualifying participants.

In addition, multiple small businesses could choose to band together to provide health coverage for their employees under plans that also would not be regulated by the state insurance commissioner or subject to ACA rules and regulations.

Senate File 2349 would create "a type of multiple-employer welfare arrangement" that would allow small businesses to associate for the purpose of offering health coverage to employees. Backers noted the coverage would not be insurance but would function similarly to insurance for Iowans looking for affordable plans to protect against major health issues.

"The cost of health care is the No. 1 concern facing our members," Farm Bureau President Craig Hill said in a statement. "Although it isn't meant to be a solution for all, we are pleased that lawmakers and the governor agree it is an option for thousands who need an affordable health plan that works until Congress passes a permanent solution to the ACA-inspired health care coverage crisis."

Hill noted his organization has provided individual health insurance statewide to Iowans in partnership with Wellmark since 1969. He said the legislation will not diminish or impact Iowans receiving ACA-subsidized coverage, but it will provide an opportunity to create coverage for Iowans who don't qualify for the ACA subsidy or have been forced out of the market by exorbitant premiums.

His company anticipates benefits possibly being available by January 2019 with enrollment applications to be opened for members in the fall of this year.

Wellmark officials Laura Jackson and Cory Harris said the Farm Bureau will develop its self-funded plan design in coming months. Wellmark will provide access to its health insurance network and will administer claims based on the Farm Bureau's plan design.

The Farm Bureau will come up with the product design and set the price for the health benefit plan.

"There's a continuum. Somewhere in that continuum this product will fall. Where that line is exactly is for Farm Bureau to determine," Harris said. "I think it will look an awful lot like what's in the market today."

(c)2018 The Gazette (Cedar Rapids, Iowa)