Ardnt: Medicaid needs expanding


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What would you say if I told you that we have the opportunity to give health insurance to 150,000 uninsured Iowans this year? Would you be interested? Maybe, but you probably would want to know how much it would cost.

Well, to be honest, it wouldn’t cost state government a cent for three years, and after that, the federal government would pay up to 90 percent of the cost from year to year.

Seem like a good deal to you? You’re not the only one; both traditionally liberal and conservative organizations across the state have come out strongly in favor of the proposal, including the Iowa Hospital Association, the Iowa Medical Society, and AARP.

The opportunity I’m talking about is Iowa’s chance to approve a Medicaid expansion as part of the Patient Protection and Affordable Care Act, better known as Obamacare. A poll conducted in January by the American Cancer Society found that 57 percent of Iowans support the Medicaid expansion, while only 27 percent oppose it, with the remaining 16 percent unsure.

So why does Gov. Terry Branstad oppose expanding Medicaid to cover an additional 150,000 Iowans? Because he is worried about increasing the national debt and having to pay it down in future years, which at first glance seems like a legitimate criticism.

But it only seems legitimate until you consider that at least 22 states and the District of Columbia already participate in the program, and that we are going to have to help pay for their Medicaid expansion through federal taxes whether we approve it or not.

Branstad’s reasoning seems even weaker when you realize that if we don’t approve Medicaid expansion, then we are going to have to pay for the 66,000 people in IowaCare when its federal waiver expires at the end of 2013, 66,000 people who would be covered under the expansion.

His illogic is especially glaring in light of the fact that IowaCare, which he has suggested he may expand or reform in lieu of approving the Medicaid expansion, does not cover services for mental illness or prescriptions, and that the only two places to receive care in the state are Iowa City and Des Moines, hardly helpful for a chronically ill person living in western Iowa.

Branstad has repeatedly said he wants to make Iowa the healthiest state in the country. What better first step toward that goal is there than giving 150,000 uninsured Iowans health insurance? Already, conservative Republican governors all over the country have changed their minds on this issue and are expanding Medicaid in their states, including John Kasich of Ohio and Jan Brewer of Arizona. If Branstad is serious about making Iowa healthier, he should follow suit.

Kelly Arndt
UI graduate fellow

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