Iowa's insurance commissioner has approved a one-year extension for thousands of Iowans with insurance policies that don't meet the requirements of the Affordable Care Act.
The commissioner, Doug Ommen, announced the approval Thursday, about a week after the Trump administration said it would allow the extension through the 2019 calendar year.
Ommen said about 38,000 Iowans have these policies, which were purchased after the passage of the Affordable Care Act in 2010 but before its major provisions took effect in 2014.
If the extension isn't approved, Ommen said, the vast majority of the people with these policies would see rate increases of between 100 percent and 400 percent.
Most with the policies don't qualify for premium tax credits, which can be used to offset much of the increase, Ommen said.
"I appreciate (the administration) continuing to give states flexibility in this regard as has been done each year since 2014, because without transitional plans as an option for these Iowans, most would likely join the up to 26,000 Iowans that have fled our ACA-compliant individual market this year," he said.
Some critics have said the continuing extension of the policies contribute to a sicker ACA insurance pool, raising costs.
Iowa's ACA marketplace already faces significant challenges, as premiums have skyrocketed. There was only one insurer, Medica, selling policies for 2018, though Wellmark Blue Cross and Blue Shield has said it plans to participate in the ACA exchange for 2019.
In addition, the Republican-led state legislature and Gov. Kim Reynolds have approved legislation this year that would allow Wellmark, in partnership with the Iowa Farm Bureau, to sell health benefit plans that are expected to have lower costs but that don't technically count as insurance.
The law would allow such plans to skirt ACA coverage requirements.