mr. gerhart. >> let the states have more flexibility. another is the accountable care organizations and the alignment of the providers and having skin in the game to keep the patient live and healthy is something we need to focus on. >> thank you. in my state, we are seeing the care. in your states are they formed as well? >> we have quite a few in iowa. >> we are looking at a different model in wisconsin, but increasing partnership with the medical providers. >> okay, thank you. >> some. >> okay. all right, commissioner? >> i think what's been talked about here is allowing insurance companies to be able to innovate and make changes without being unduly impeded. at the same time, you need to have the standardization so they maintain respective standards. you don't want them gaining the system to get the healthy people at the expense of the less well. it's very harmful to the market and certainly to the individual group market that we have right now. so, it's really starting to have some standardization here. standards, at the same time,

mr. wieske. i believe senator ernst would like to introduce our next witness. >> it is my honor to introduce nick gerhart. nick has served our great state as commissioner since february 2013. and we appreciate your service, commissioner. and he also serves on the national association of insurance commissioners executive committee. it makes him an excellent witness for us to today to talk about this important topic. thank you, commissioner for traveling to washington, d.c. to share your expertise with this committee and the audience members. thank you, commissioner. thank you, mr. chair. >> good morning, chairman johnson and ranking member carper and the esteemed members of the committee. it is an honor to be here. i want to focus on the duty of an insurance commissioner, the rates and what's happening at the kitchen table to the members of our state and the highlights to fix some of these issues. i did submit written testimony which is a much longer outline of those potential fixes. as an insurance commissioner in the state of iowa we're a state of 3 million people. we know the folks these are impacting.