Projected premium costs are expected to be lower in Iowa than in many other states. Before tax credits that will provide an up-front discount for most buyers, the premium price for a mid-range benchmark plan will average $287 a month in Iowa, according to information released by the Obama administration earlier this week. That's lower than the national average of $328 monthly.
"I think compared to other rates we've seen, we shape up pretty competitively, said Iowa Insurance Commissioner Nick Gerhart.
One question mark in Iowa remains the planned expansion of low income health care. The state is seeking a waiver enabling the state to receive more federal Medicaid money for the proposed Iowa Health and Wellness Plan, a new health insurance program that would cover as many as 150,000 residents. The plan would cover some people on a new state-run program, while others would get private plans on the exchanges, with the federal dollars paying the premiums.
But so far, the state has not received federal approval. Gov. Terry Branstad has said federal officials have questioned the plan because it includes some small premiums, though they could be waived for meeting health goals or due to hardship. Still, officials remain optimistic the program will be in place well before Jan. 1, when coverage would begin.
"The actual coverage doesn't begin until January. I think we will come to a conclusion on that," Bolkcom said.
Getting the word out to residents about the exchanges remains a challenge. Federal grant money was recently approved for a marketing campaign in Iowa, but given state contracting rules, the earliest anything would hit the airwaves would be December, said Gerhart.
"We are supplementing what the federal government is doing on outreach," Gerhart said.
Other pieces of the process won't be completely ready by Oct. 1. Three medical organizations received federal grants to hire people in Iowa to serve as Navigators, who are people specially trained to help consumers find their way through the new health insurance system. Most of those Navigators will not be ready to go Tuesday.