Iowa has submitted a request to the federal government to make changes in a last ditch effort to save the state’s beleaguered Obamacare market. From Quad-City Times:

This November, the majority of the 72,000 Iowans purchasing plans through the exchange will have only one option — Minnesota-based Medica. Last week, Medica asked the state for an average rate increase of 56.7 percent because of the uncertainty over cost-sharing reductions.

The federal payments are made to insurers to help cover costs and expand access for low-income individuals, but the future of the payments are now in jeopardy.

If the federal government approves this stopgap measure, then Wellmark Blue Cross and Blue Shield will return to the market.

These are the changes Iowa would like to make, according to The Hill:

State health officials want to reallocate hundreds of millions of federal dollars to help insurers pay for high-cost claims, as well as revamp the structure of federal tax credits that help people afford insurance.

The hope is that changing the tax credits would encourage a larger number of younger, healthier people to purchase insurance and help spread out costs.

The tax credits would provide a fixed level of financial assistance based on age and income. That’s in contrast with ObamaCare’s subsidies that are tied to the cost of health insurance plans.

“In Iowa, we face an immediate collapsing market. … Iowans deserve a healthcare system that better serves their needs,” Gov. Kim Reynolds (R) wrote in the application.

Iowa Insurance Commissioner Doug Ommen said that the state will proceed as if the government has approved the request since “open enrollment is a little more than two months away.”

He explained his concerns at a news conference and how much will change if the government doesn’t act on the state’s request. Quad-City Times continued:

One of Ommen’s primary concerns, he said, are those purchasing insurance through the exchange and living above the 400 percent poverty level — about 28,000 people — and who therefore are not eligible for subsidies. They likely would not be able to afford coverage and either would leave the insurance market or the state, he said Tuesday during a news conference.

“People who depart will be healthy, and that will leave us in an even worse circumstance,” he said.

The insurance division said a 55-year-old couple making $65,000 a year could pay as much as $33,000 annually for premiums.

“The economic impact on Iowa would be catastrophic for Iowa families, and we need the Iowa Stopgap Measure approved to help keep these individuals in our market so it can function,” Ommen said.