Today’s Rotary Club meeting featured Laura Jackson, Executive Vice President for Health Care Innovation & Business Development at Wellmark, Inc. She holds an undergraduate degree from Iowa State University and a master's degree from Marymount University in Arlington, Virginia. Jackson is responsible for sales, marketing, public relations, management and compensation of the provider network, pharmacy, health and care management, wellness, and health care sustainability and strategy.
While the program committee had no way to know they were timing Laura Jackson’s presentation for the week after Congress failed to repeal and replace the Affordable Care Act as had been predicted during the campaign, the committee deserves credit for getting Jackson to present on such a timely topic. 
Laura Jackson covered a lot of ground during her time at Rotary today. She gave an overview of the national debate about health care and provided a well-articulated prescription for what she and her colleagues at Wellmark see as needed to improve health care for Americans. Responding to Jackson by a show of hands, most of the audience indicated they felt it was more likely Congress would revisit health care and find solutions than those who thought the Affordable Care Act (ACA) would implode as some have suggested. Jackson shared her hope that good policy would win out over politics in the weeks and months to come.
As a health care insurance expert, Jackson stated she believed the potential good the ACA could be doing had been hampered by some of the compromises made to get the bill passed into law seven years ago. Today, Americans see premiums increasing, choice of coverage decreasing, and the amount consumers pay for deductibles increasing – all three of these are trending the wrong direction. To illustrate the complexity of health care insurance, Jackson cited the case of a 17-year-old hemophiliac covered by Wellmark whose care is running $1 million a month. To get this patient the care he needs, Wellmark must be able to spread costs across a wide pool of insured people, and the company must be able to access reinsurance options.
The coverage pool for the 6 million Americans covered by ACA plans is not sustainable, and options for these Americans are few. According to Jackson, 33% of those in this pool have a single choice of insurance providers, 37% have two choices, and 30% have three or more. Approximately 162,000 Iowans are purchasing their own health care insurance. Those who are covered by pre-ACA plans pay an average of $315 per month. Those with ACA plans pay around $560 per month.
Jackson offered three guiding principles for reforming the ACA. 1) Legislation must include a mandate for coverage, Americans must be required to be insured. 2) Insurers like Wellmark should have access to reinsurance (think about the $1 million a month patient cited above). Reinsurance essentially creates high-risk pools to share high costs across markets. 3) Insurers should be allowed flexibility to design plans that meet consumers’ needs. Jackson dismissed the suggestion that opening the sale of health insurance policies across state lines would benefit policyholders. Doing so would leave many underinsured or with inferior products Jackson explained.
Like most Americans, Jackson wonders if elected officials have the will to meet the challenge.
Jackson closed with an excellent message about the importance of leading a healthy lifestyle. A well-rounded diet balanced with regular exercise is the best recipe for individual health and for holding care costs down as a nation, this is one area that should be easy for all of us to find agreement.
See you next Thursday at Rotary!