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Iowa asks to rewrite Affordable Care Act rules to prop up its insurance exchange

The Washington Post: Iowa is asking the Trump administration for permission to jettison fundamental aspects of its Affordable Care Act marketplace, contending that a large-scale rewriting of the rules is the only way to prevent the state from becoming the first without any health plans available under the law next year.

In an extreme plan that Iowa’s insurance commissioner submitted to federal health officials on Monday, the state would essentially take an estimated $350 million in federal ACA money that its residents and insurers would ordinarily receive next year and use it for different purposes.

The proposal would abolish Iowa’s ACA insurance exchange and, unlike anywhere else in the country, give some people federal help in paying for coverage outside the marketplace. It would eliminate the law’s subsidies for insurance premiums and out-of-pocket costs, instead creating a different type of tax credits resembling those favored by House Republicans. It would also replace tiers of coverage with a single level of insurance for customers buying health plans on their own.

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