Accepting Future Changes to Iowa Health Insurance Policies

Insured Iowans are ready and willing to accept future changes in health care delivery and health insurance.

While more than eight out of ten (83%) Iowans rate the current quality of their own health insurance coverage as at least reasonably good, their sense of satisfaction does not appear to stand as a barrier to embracing change. Insured Iowans show support for change through attitudes revealed in this survey:

• Greater use of allied health professionals. A solid majority of 64% are willing to make greater use of clinics staffed by nurses and physician's assistants rather than physicians.
• Higher deductibles. Overall, 52% of insured Iowans would be willing to accept a health insurance policy with a higher deductible to keep their premium costs down. Not surprisingly, those with the highest incomes rate this change more favorably (61% of those with incomes greater than $70,000 are willing to go to policies with higher deductibles compared to 48% with incomes of $50,000 or less).
• Larger co-payments. A near majority (48%) would be willing to accept a policy with higher co-pays for physician visits and prescription drugs, though support drops to 39% among insured Iowans with incomes below $30,000.

In a finding that will not surprise health maintenance organization executives, insured Iowans show a limited willingness to choose health insurance policies with fewer participating doctors and hospitals. Thirty percent (30%) say they are willing to make that change to keep their premium costs down. Additionally, 40% of insured Iowans are willing to reduce the number of physician visits they or members of their household make to keep insurance premium costs down.

Interpretation

The reality of the economic pressure of rising health insurance rates lead Iowans to embrace changes to health care and health insurance. However, for changes to be broadly supported, they should not interfere with Iowans' ability to choose from an extensive physician panel, nor impose external limits on their physician usage. Additionally, changes which carry additional out-of-pocket costs for low-income insured Iowans find less support among those for whom co-payments for physician visits and pharmaceutical products may become a hardship.

The conclusion we draw is that cost pressures are changing health insurance plan design as well as how benefits are actually used by plan members. These changes are occurring parallel to on-going incremental health care system reforms. A full understanding of how increasing costs are changing when and how Iowans consume health care resources may well reveal that the cumulative effect of cost increases on the health care system will override changes arising from incremental reforms.