Did President Donald Trump really personally kill off Iowa’s request for a stopgap measure, risking tens of thousands of Iowans’ health insurance just to make a political point? Has the Centers for Medicare and Medicaid Services (CMS) actually made a decision yet? What did Governor Kim Reynolds know about the federal government’s position in the process? Was her administration caught flat-footed over reports that Trump opposes the waiver approval, and why hasn’t she been able to get a call returned from the president yet?
The answers to those questions are crucial to the 72,000 Iowans on the ACA exchange who are quickly running out of healthcare options for next year, so the Iowa Democratic Party filed a freedom of information request today with the governor’s office to find out. IDP Executive Director Kevin Geiken sent a Freedom Of Information Act (FOIA) request to Reynolds’ staff to figure out what exactly the Reynolds and Trump administrations have discussed when it comes to the CMS waiver.
Geiken’s letter requested:
“Any and all records and correspondence from May 1, 2017 through the date this request is received, including but not limited to emails, faxes, records of phone calls, invoices, or text messages, between the Office of the Governor, the Office of the Lieutenant Governor, or Iowa Insurance Commissioner Doug Ommen and President Donald Trump, Department of Health and Human Services Secretary Tom Price, CMS Administrator Seema Verma, or any employee of HHS or CMS.”
To read the full IDP letter, click here. By Iowa law, Reynolds’ staff have ten business days to respond to the request.
“Governor Reynolds admitted she failed to advocate for our state when she met with the President, and now healthcare for tens of thousands of Iowans is at risk,” Geiken told Starting Line. “With so much dysfunction both here in Des Moines and in D.C., Iowans deserve complete transparency from our current governor and the White House. Neither has owned up to that responsibility, so the Iowa Democratic Party is trying to get to the bottom of this mess with this FOIA request.”
At issue here is the future of the individual healthcare market on the ACA exchange in Iowa for 2018. Earlier this year, most of the healthcare insurer companies announced they would leave the Affordable Care Act exchange in Iowa due to uncertainty over the program’s future thanks to Republican efforts to undermine the law. Medica was the only company that said they would remain on the individual market, but the premiums on their plans would jump about 58% next year. Iowa estimated that around 20,000 people would drop their plans, leading to more instability.
Iowa Insurance Commissioner David Ommen, working with major insurer Wellmark, came up with a stopgap measure that would utilize a waiver in the ACA to redirect federal funds to reduce risks to insurance companies and stabilize Iowa’s individual market to an extent. That could bring Wellmark back onto the market. However, that required federal approval from CMS to move forward.
The Washington Post reported last week that President Trump personally intervened with CMS, telling CMS head Seema Verma reject Iowa’s request. Trump had reportedly read about Iowa’s situation in a newspaper article and hoped to weaken the ACA exchange in Iowa even more, despite his Republican allies in the state work to stabilize it with a more conservative-leaning alternative.
Since that report, confusion has reigned in Iowa over what’s actually going on with the waiver request. When asked at a White House press briefing, Sarah Huckabee wouldn’t confirm or deny that Trump had intervened.
“I’m not aware of that specific directive, so I’d have to check into that and get back to you,” Huckabee told a reporter last week.
Iowa officials said late last week that they hadn’t been informed by CMS that their request was rejected. At Reynolds’ press conference yesterday, the governor said her administration was still working with CMS on the issue (the registration period for next year’s exchange starts on November 1st, however, and some wonder if it’s too late to implement the stopgap measure anyway). Back in June when Trump visited Iowa, Reynolds told reporters she would meet with the president, bring up Iowa’s stopgap measure and encourage him to sign onto the plan.
“I haven’t spoken directly to the president. I’ve asked for a conversation,” Reynolds told reporters, adding that her staff were on the phone with Verma the day before.
All of this has led to widespread criticism of Iowa Republican leaders, who bent over backwards in 2016 to prove themselves loyal to Trump, only to get potentially stabbed in the back by the president when they needed some key help for Iowa’s insurance exchange.
There’s three potential situations here of what’s going on with Reynolds and the Trump Administration, none of them good:
1. President Trump did preemptively intervene to kill off Iowa Republicans’ request for their stopgap measure, and CMS is simply stringing the state along for the time being. All of the good will that Iowa Republicans built up with Trump during and after the election gained them zero influence, and now Reynolds can’t even get a call with the president on a crucial, time-sensitive issue.
2. Due to ineptitude, the Reynolds Administration hasn’t stayed on top of the situation, leading to the current confusion. The IDP’s FOIA request should show just how often Reynolds’ staff kept in touch with CMS, especially as the drop-dead date for approval grew closer.
3. Reynolds and her administration doesn’t actually care about stabilizing Iowa’s healthcare market, and is willing to risk tens of thousands of Iowans’ healthcare access in order to score political points for national Republicans by undermining the ACA.
The Democrats’ information filing should help bring some better clarity on to what is going on with the future of tens of thousands of Iowans’ health insurance. Whether it’s sabotage, incompetence or disinterest may be revealed by what communications are uncovered by this FOIA.
by Pat Rynard