Health insurance co-op may be golden ticket

by TONY LEYS, The Des Moines Register  |  published on December 24, 2012

Health insurance co-op

Cliff Gold jokes that he sometimes feels like Michael Corleone, the reluctant mobster from the Godfather movies.

“Just when I thought I was out, they pull me back in,” Corleone famously complained after a failed attempt to escape the mafia life.

The don’s workdays included ordering hits against rivals. Gold’s career has been a bit less dramatic. He spent 30 years designing and marketing health insurance plans. He retired in 2008 from Wellmark Blue Cross & Blue Shield, the Des Moines-based giant where he’d been a top executive. He was relaxing in San Diego, where he planned to live part time, when his friend David Lyons called from Iowa in 2010 with a proposition he couldn’t refuse.

Congress had just passed a sweeping health reform law. An obscure part of it aimed to encourage a new kind of health insurance organization, under which consumers would join together to form their own carriers. The idea would be similar to the co-ops that rural residents formed to deliver electricity and farmers formed to buy supplies and market crops.

Lyons, a former state insurance commissioner, thought Iowa could be a perfect spot for such an effort. Wellmark controls 86% of the state’s market for insurance sold to individuals and 64% of policies sold to small employers. No other carrier has more than a few percentage points.

Lyons predicted Iowans would be hungry for a new option, and he asked his friend to join him in offering one. Gold was hesitant at first, but he believed Lyons was onto something. Within a few months, he was back in Des Moines, helping his old colleague write a proposal.

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