The Register's editorial

Iowans have now received what the Republican-controlled state Legislature and Gov. Kim Reynolds ordered: the option to buy unregulated health plans that can deny coverage, suddenly cancel plans, not pay medical bills and face no repercussions.

The Iowa Farm Bureau last week unveiled details about its new health plans, which are supposed to offer an alternative to policies that must comply with requirements in the Affordable Care Act. These "health benefit plans" are not health insurance, not subject to basic coverage requirements and not regulated by any state or federal entity.

If you think that doesn't sound like a big deal, just wait until you need health care.

Sen. Mark Chelgren, R-Ottumwa, was among the state lawmakers who supported a bill last spring clearing the way for the free-for-all plans. “We have tried this before,” he said at the time, referring to the individual health plans available for Iowans to purchase before the ACA. “This was how our system worked.”

Ah yes, the good old days before Obamacare. Let's reflect on how the health insurance system worked before the reform law.

People without coverage through a job or government program like Medicare tried to buy insurance on their own. Those with pre-existing health problems found insurers would not sell them a policy. Or the premiums were sky-high and not affordable. Or insurers offered plans specifically tailored to exclude benefits.

For example, someone with diabetes may have been able to buy a plan, but that plan didn't cover insulin, test strips or any care related to the disease. Someone who had knee problems years earlier might be offered a policy excluding any care for knees.

Millions of Americans paid a fortune for coverage, bought inadequate policies or were uninsured. When people got sick and their coverage was canceled, there was no recourse. This mess, which Chelgren and other Republicans apparently long to revive, was the driving force behind congressional passage of Obamacare.

That law protects Americans. It requires insurers to cover the health care people actually need, like prescription drugs and emergency room visits. It created state-based marketplaces where private insurers offer comprehensive plans and are required to cover all applicants, regardless of health. Federal subsidies frequently help fund premiums, and customers are pooled together to spread risk and cost.

Iowa lawmakers and Reynolds proactively undermined this entire concept.

They paved the way for Farm Bureau to cherry-pick and insure healthier, less expensive Iowans. This could leave the insurers participating in the exchange with more expensive patients, which could drive up the cost of premiums for everyone else.

Iowans considering a Farm Bureau health plan should think twice. First, check whether you qualify for Obamacare subsidies to help you buy insurance. Federal subsidies will not help pay for the Farm Bureau plan. If you encounter any problem — from your coverage being abruptly dropped to your medical bills not being paid — no outside entity will be there to help. You will truly be on your own.

And the importance of Obamacare's regulations and patient protections will be painfully apparent.