Faced with the possibility of having no insurance company selling on the Obamacare exchanges in the state, Iowa has applied for a 1332 innovation waiver under provisions of the Affordable Care Act (ACA).

If approved, Iowa will sell just one standard policy on the ACA exchange and will back it up with tax credits to help individuals afford the coverage.

“This does not fix all of the problems we’ve seen in [Obamacare] but it dramatically impacts the rates that people without subsidies would otherwise face and likely leave the market,”  Iowa Insurance Commissioner Doug Ommen told the Washington Examiner.

The state would also establish a reinsurance pool to help insurers cover the costliest (sickest) policyholders.

Under 1332 waivers, states are allowed to experiment but they must prove that coverage does not drop in numbers and that costs to policyholders remain the same. Though officials expect this plan to reduce its insured population by 4,o0o to 6,000, they argue that this is better than the 18,000 to 22,000 they will lose if the plan is not approved.

Medica is the only insurer selling in the state for 2018, but Wellmark Blue Cross and Blue Shield said it would sell in all 99 of Iowa’s counties if the waiver is approved. The state is seeking swift approval of the waiver since it must sign insurance contracts by Sept. 27. Waivers generally take 180 days for approval.