Credit: Shutterstock
An insurance regulator in a Republican-led state in the Midwest is making a point of encouraging people who now use individual health insurance coverage to try to sign up for employer-sponsored health plans.
Doug Ommen, the Iowa insurance commissioner, said in a press release posted Tuesday that consumers facing skyrocketing costs for individual or family coverage purchased through HealthCare.gov should look to see whether they can get coverage from an employer.
Iowa consumers should talk to licensed insurance agents or health system navigators about their 2026 coverage needs, and they should "also consider whether employer coverage, short-term limited duration plans (STLD), farm bureau plans, direct primary care arrangements, or other non-ACA options better fit their needs," according to the release.
What it means: Ommen is a veteran insurance regulator who is active at the National Association of Insurance Commissioners.
If he is actively promoting use of employer coverage as an alternative to individual coverage, regulators in other Republican-led states could do the same.
Some states have their own locally run ACA public exchange programs, or web-based health insurance supermarkets, but states with Republican governors typical use the federal government's HealthCare.gov public exchange program.
Major medical coverage basics: Short-term health insurance plans are policies that do not have to meet ACA benefits or underwriting requirements and can stay in place for up to 36 months in some states.
Farm bureau health plans and direct primary care arrangements are state-regulated health care purchasing arrangements that some states classify as not being insurance.
The health cost backdrop: Health insurers are now warning that their individual premiums could rise 10% to 30% or more in 2026 because of overall health care cost inflation and concerns about federal health rule and funding changes.
Congress is debating whether to extend the current high level of ACA health insurance premium tax credit subsidies.
Letting the extra subsidies added in response to the COVID-19 pandemic could cause some people's share of the premiums to be four times as high in 2026 as they are today.
For some moderate-income consumers, the looming changes mean that coverage that costs less than $100 per month per insured out of the consumer's own pocket today could end up costing more than $500 per month in 2026.
The employer impact: One question is how many people with ACA individual exchange coverage will really affect employers.
Analysts at the Congressional Budget Office have predicted that, if the current ACA subsidy levels expire, about 400,000 of the 1.8 million who would be severely affected by the change might have access to employment-based health coverage.
The ACA exchange exiles flowing into employer plans might be cost-conscious people who are healthier than usual and will have below-average claims, but, if they have been using low-cost, bare-bones exchange plan coverage, they could also be people who have neglected routine sick care and will be more likely than other new plan participants to have severe claims.
© Arc, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to TMSalesOperations@arc-network.com. For more information visit Asset & Logo Licensing.