Best news I’ve heard in a while: Coventry has told the Des Moines Register’s Tony Leys that it will continue to sell health insurance through Iowa’s exchange during 2016. Since the collapse of Co-Oportunity Health, Coventry has been the only provider selling individual and family policies on Iowa’s exchange. If the company had opted out for 2016, roughly 40,000 Iowans who qualify for federal subsidies would have had no way to obtain that assistance, likely pricing them out of health insurance for next year.

The 800-pound gorilla of Iowa’s insurance market, Wellmark Blue Cross/Blue Shield, will yet again opt out of our state’s exchange in 2016, Leys reported. Iowa’s Insurance Commissioner Nick Gerhart lacks the power to force Wellmark to sell through the exchange, because Governor Terry Branstad insisted on forming a “partnership” exchange with the federal government, rather than a fully state-based exchange.

More competition in Iowa’s health insurance market would be preferable; currently West Virginia is the only other state with just one company selling policies on the exchange. Still, Coventry’s decision to stay for next year removes a huge threat to the well-being of thousands of Iowa families. I was worried that Coventry would cut their losses here after taking on most of the relatively expensive former Co-Oportunity customers.

The U.S. Supreme Court’s pending ruling in King v Burwell remains another potential threat to the 40,000 Iowans who rely on federal subsidies to make health insurance affordable. It’s not clear whether the Republican-controlled Congress could pass a fix if the high court rules that those subsidies are not allowed for Americans who purchase health insurance through the federal website. Some Republicans would be willing to address the problem to preserve access to health care for millions, but others would insist on a full repeal of “Obamacare,” the 2010 Affordable Care Act.

UPDATE: At least one other company will also offer health insurance for 2016 through Iowa’s exchange. Excerpts from Leys’ updated report for the Des Moines Register are after the jump.

The headline for Tuesday’s Des Moines Register was Wellmark Blue Cross/Blue Shield opting out of Iowa’s health insurance exchange, but good news came further down the page.

UnitedHealthcare, the nation’s largest health-insurer, confirmed Monday evening that it plans to start selling policies to Iowans this fall on the online public marketplace, known as HealthCare.gov. […]

Insurance Commissioner Nick Gerhart said he expects a third, unidentified company to file an application this week to sell policies to Iowans on the exchange. Companies must declare this week whether they will be selling plans to Iowans on the public exchange.

Meanwhile, Wellmark’s decision to avoid the exchange has reduced the number of Iowans receiving subsidies to purchase health insurance, as foreseen under the 2010 Affordable Care Act.

Most Iowans who make less than 400 percent of the poverty level – or about $47,000 for a single person – can qualify for Affordable Care Act subsidies to help pay for premiums. But only about 38,000 Iowans – about 1 percent of the population – have received such subsidies, averaging $260 per month. Iowa has one of the lowest participation rates in the country, and a national expert said that’s partly because the state’s main insurer is not participating. […]

A Kaiser Foundation analysis found that just 20 percent of Iowans who could have qualified for premium subsidies last year took advantage of them, which was the lowest level in the country. South Dakotans, at 21 percent, were the second-least likely. “That seems like more than a coincidence,” [Kaiser Family Foundation Senior Vice President Larry] Levitt said. The national average was 42 percent. Mississippi’s rate was 37 percent.

Levitt said some Iowans probably made a rational choice to maintain their unsubsidized Wellmark plans rather than accept a small public subsidy to switch to an unfamiliar carrier. But he said other consumers might not be aware of their options because the main insurer in the state is not using its marketing muscle to promote the subsidies.

During the open enrollment period last fall, I heard numerous radio ads for Wellmark, urging people to sign up for health insurance policies. Naturally, the Wellmark ads did not call attention to the fact that Iowans buying insurance through that company (rather than through the exchange) would not be eligible for federal subsidies.