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Medicaid expansion receives support from Iowa Senate

BY LAUREN COFFEY | MARCH 26, 2013 5:00 AM

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The Medicaid-expansion debate has been ongoing, fueled by Gov. Terry Branstad’s alternative health-care proposal, and the Iowa Senate has weighed in, passing a bill to expand Medicaid on a vote of 26-23.

“It is not the Iowa way to turn our backs on 100,000 uninsured Iowans,” said Sen. Pam Jochum, D-Dubuque. “We’d like the governor to believe in an integrated health-care system.”

Medicaid is a federal-state program that provides public health insurance for low-income people.

Under the Affordable Care Act, the federal government will provide additional funding to states to expand access to Medicaid.

Iowa uses Medicaid as well as IowaCare, which serves uninsured Iowans who cannot get Medicaid. IowaCare is set to expire this summer, and proponents talk about the expansion of Medicaid to replace the current system.

The Iowa Democrats supported an amendment in passing Medicaid expansion — if the government does not pay for the expansion of Medicaid, Iowa can withdraw from the expansion.

While Democrats on the whole push for an expansion of Medicaid, Republicans look at other options.

Earlier this month, Branstad unveiled his proposal for health care, the Healthy Iowa Plan. His plan, if passed, would provide reimbursements for tax credits from private insurance instead of the state government. The Healthy Iowa Plan will cover approximately 89,000 uninsured Iowans earning below 100 percent of the federal poverty line. There is not an official bill for his plan yet.

“The Healthy Iowa Plan has not been released in the form of a bill yet, so we think it’s best to wait until it comes out to review it in detail,” said Sen. David Johnson, R-Ocheyedan. “[Medicaid] is not the only option the state has. It’s being sold as the only option and it’s not the only option. We’re voting on two education-reform plans that are different, two property taxes that are different, and budgets for the House and the Senate that are different. [Voting on health care] shouldn’t be any different.”

Tim Hagle, a political-science associate professor at the University of Iowa, said the debate between the health-care options boils down to states taking the faster fix of Medicaid or creating their own plans.

“You do have Republican governors and Democrat governors that are going to go with Medicaid under Obamacare,” Hagle said. “Even Republicans realize this is a long-term problem, but this is short-term money. Other governors, like Branstad, take the longer route.”

The Democrats’ key attacks against Branstad’s plan were its cost, and they said that it would still leave some Iowans without health insurance.

“We do have one detail, Sen. Johnson, [on Branstad’s plan],” said Senate Majority Leader Michael Gronstal, D-Council Bluffs. “[Branstad’s] plan will leave out 65,000 Iowans because he stops at 100 percent of poverty.”

Numerous senators discussed cost in depth at the Senate discussion.

“We are struggling with funding school reform; we are struggling with funding property taxes,” said Sen. Jack Hatch, D-Des Moines. “Yet $167 million is going to something that could be funded by the federal government.”


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