State Net Capitol Journal: Iowa Governor Issues Alternative to Medicaid Expansion

Iowa Gov. Terry Branstad (R) last week unveiled an alternative to expanding Medicaid in the Hawkeye State. Under federal health care reform, states are given the option of expanding their Medicaid eligibility to cover people living at up to 138 percent of the federal poverty line. In Iowa, that would add about 150,000 new enrollees into the system.

But Branstad opposes the expansion. Last week, he instead proposed replacing the state's current health care program for poor adults - IowaCare - with a new one called the Healthy Iowa Plan that would cover only about 89,000 of those currently uninsured Iowans. IowaCare currently covers around 67,000 people. Enrollees would pay a small premium and get care at specific clinics, which he said would be paid to keep people healthy rather than just to treat them when they are sick. Branstad also claimed the federal government would pick up about 60 percent of the tab.

Democrats quickly voiced skepticism, noting the federal government has agreed to pay 100 percent of the expansion cost for three years, and then 90 percent from that point on.

"His plan would cost us $50 million more and cover half as many people," Senate Majority Leader Michael Gronstal (D) told the Des Moines Register. "It's fiscally unsound."

Branstad also angered some Dems by comparing the uninsured to wedding guests at an open bar, saying everyone had to "have some skin in the game."

The governor said he has already pitched the idea to federal officials, who must ultimately approve or reject it. (DES MOINES REGISTER, STATE NET, IOWA CITY PRESS CITIZEN)

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