U.S. House Rep. David Young, of Iowa’s third district, used his weekly report to discuss the state of health care in Iowa. Young explains why changes to the Affordable Care Act are needed, particularly by Iowans.

He explained in his weekly report that Aetna and Wellmark Blue Cross and Blue Shield plan to pull out of Iowa’s individual health insurance market for 2018. The Des Moines Register reported Medica would follow in their footsteps.

So what does this mean for Iowans? If you do not receive insurance from Medicare, the VA or your employer, you won’t have an insurance option – and under the Affordable Care Act, will be fined for not having insurance.

It means over 70,000 Iowans in 94 of Iowa’s 99 counties would be denied access to health care coverage. These 94 counties would in effect become health care access deserts, according to Young’s report.

“Last week, the U.S. House of Representative took action,” Young said. “We voted and passed the American Health Care Act. This legislation, while not perfect, took the necessary step forward to help provide stability in the market and move the conversation to the U.S. Senate so we can, hopefully, fix our broken health care system and the failing Affordable Care Act law.”

The third district is in the southwest corner of the state, and includes Des Moines. Ames is represented by Steve King, along with the rest of the fourth district and northwest Iowa.

ISU faculty explain the AHCA

Mack Shelley, chair of the political science department, answers a few questions on the Affordable Health Care Act passed by the House in May.

Q: Can you expand on some of the possible motivations for this bill?

Shelley: It’s largely driven by ideological preferences for “smaller government” and for using public funds and legislation to support big business and corporate power. The bill includes tax cuts approaching a trillion dollars over several years for upper-income people who currently are funding a large part of the Affordable Care Act.

Q: Can you provide context for how the previous healthcare act (termed Obamacare) affected Iowans, including any negative and positive impacts?

Shelley: The primary positive effects are coverage for more people including those who did not have any health insurance, helping those with preexisting conditions to get better service at an affordable cost and extending coverage of children to age 26.

The Affordable Care Act is associated with rising health care premiums (although that largely happened when people got higher-quality coverage) and with driving out health insurance providers (probably due to making it more difficult for those providers to gauge their clients for low-quality care at high cost).

Another dimension to the ACA is that it was an attempt to square the circle of expanding care within a private sector system that is designed less to benefit patients than to generate profits for the health care industry; in some respects (e.g., individual mandate) the ACA is really a Republican bill that omitted a public option and is pretty much the antithesis of a single-payer system of health care that applies in just about the entire rest of the planet.

Q: Can you explain what is likely to happen in the Senate, and what the possible path for the bill in the legislature could be?

A: The Senate is likely to pass an adjusted version of the House APHA and probably will focus on block grants to states and eliminate ACA provisions for Medicaid support. States like Iowa could then be in the position to further reduce public funding for health care needs.