There has been a great deal of concern about the increased costs of health insurance premiums lately. I have been hearing about double-digit increases, many over 20 percent. For individual policy holders, small businesses, and employers it can be crippling.
I know that access to health care is a common area of discussion, and it should be. I am proud of Iowa’s record in regard to the coverage of our children. Equally important, though, is affordability. There is not a week goes by that I do not hear about insurance affordability issues. At the federal level I do not believe that either the Obama plan or the Republican plan will significantly affect affordability, and if we are not careful we may actually make the problem worse.

No one has all of the answers and without a plan that includes ideas from both political philosophies, I believe the federal government will have missed the best opportunity for affordability reform in recent years. The answer is not in ramming the Obama plan through on a straight party-line vote, nor is the answer a vote of “no” without serious negotiation with the President. The political rhetoric from the extreme in both political parties is not helpful in finding solutions.

So what can the State of Iowa do? We are certainly limited in what a state of three million can do in a market of hundreds of millions. I strongly believe that the federal government needs to allow large insurance companies to be governed by our anti-monopoly laws. Some of our insurance companies have a market share that is not lending itself to fair competition. I believe the feds should also allow the sale of insurance across state lines. This could also help the 60 percent plus market share that Wellmark (Blue Cross/Blue Shield) has on the Iowa market. Right now the free market is inhibited in Iowa.

Last week I was the lead Republican Sponsor on a bill that stopped the practice of the dental insurance companies from setting prices on dental services that they do not cover in their plan. I hope the Senate passes the bill and we stop this practice. Not only did this lack fairness, it was discouraging dentists from participating in our Medicaid programs.

Affordability is not all the fault of insurance companies. We must acknowledge that every time we place a mandate on an insurance plan, that mandate then becomes a factor in rate increases. I have never seen a mandate that was unnecessary or not motivated by the best of intentions ... I take each one on its own merits and try to make the best decision, but I am always keenly aware that they do raise rates.

Other factors like lab and hospital costs, malpractice insurance rates, and not fully funding Medicaid are also affecting health care costs. To totally ignore frivolous lawsuits in the national discussion is simply not justifiable. At the state level every time we underfund Medicaid, we add more financial burdens to customers.

A few other ideas that merit discussion at the state level and could affect affordability of health care and health care insurance include:

• Statewide catastrophic plan and pool

• Aggressive tax credits focused specifically on the individual and small business market

• Much greater transparency in health care costs, including public posting of actual costs, administrative salaries, and true profit margin numbers

• Aggressive wellness incentives

• Creation of a knowledgeable health care consumer with multiple options/choices

• Availability of mandate-free policies for purchase

Are my ideas all correct? No. Are there better ones out there? Yes. I do know one thing for sure; the best solutions will not be embedded in political rhetoric.

Capitol visitors: Makenzie Maas, West Branch



You may contact Rep. Kaufmann at jeff.kaufmann@legis.state.ia.us, 515-281-3221 or State Capitol, Des Moines, IA 50319.