Iowans facing tough financial challenges packed a Senate subcommittee Monday to urge state senators to expand Medicaid coverage to another 150,000 state residents.
“Expanding Medicaid for Iowans is desperately needed. We know with our heart that it is the right thing to do and we know with our head that it makes sense,” said Lou Ann Burkle, a Des Moines woman whose adopted 22-year-old daughter no longer qualifies for Medicaid and has difficulty getting proper care through the state’s IowaCare program because some programs are full.
“To deny Medicaid for our loved ones and the most-vulnerable citizens of Iowa is heartless, unjust and immoral,” she testified. “Iowa needs to save and expand Medicaid. It is the right just thing to do.”
Burkle’s situation and comments were mirrored by a number of speakers and working poor Iowans, who pressed Iowa’s lawmakers to take advantage of a Medicaid expansion offered under the federal health-care reforms. Senate File 71 would broaden state eligibility requirements for Medicaid, which covers low-income residents, including children and the disabled.
Dawn Francis of the Iowa Statewide Independent Living Council said expanding Medicaid would provide access to essential heath services to thousands of Iowans who currently are ineligible for Medicaid, potentially save lives, improve people’s productivity and keep them out of expensive institutions which would save money and help meet Gov. Terry Branstad’s goal of making Iowa the healthiest state in the nation.
“Medicaid expansion represents new federal dollars available to Iowa. These otherwise unavailable federal dollars will create jobs, provide new state tax revenue and stimulate the state economy,” Francis said. “Medicaid expansion is a win-win-win: it increases health care access, secures hospital finances for the future and strengthens Iowa’s economy."
Starting Jan. 1, 2014, the new federal law expands Medicaid eligibility to people making up to 138 percent of the federal poverty line, or about $15,400 for an individual. Under the law, the federal government will pay the full cost of the expansion the first three years, from 2014-2016. Thereafter, the federal share gradually phases down to 90 percent, still way more than the government pays for the rest of Medicaid.
Branstad, citing concerns about the cost, reiterated his opposition to expansion, even though six fellow GOP governors in others states have decided to expand Medicaid rolls in their states. He noted that 27 GOP governors have not and he remained hopeful of getting a federal waiver for more flexibility in dealing with health care costs and continuing the IowaCare program -- a state and federally funded plan that provides limited health coverage to low-income adults from ages 19 through 64 who are not otherwise eligible for Medicaid. The purpose of IowaCare is to provide some health care coverage to people who would otherwise have no coverage.
“We’re going to continue to monitor the situation,” Branstad said in an interview. “We’re seeking more flexibility and we’re also looking at alternatives – is there a possibility to get a waiver where we can put something in place that’s more consistent with our goal of being the healthiest state? We’re going to continue to look at the situation.”
While the legislator took steps to expand access to IowaCare through regional health-care centers, Sen. Joe Bolkcom, D-Iowa City, told subcommittee members the program is “limping along” and presents a hardship to Iowans who cannot afford transportation to get care and often can only get specialized services at the University Hospitals & Clinics in Iowa City.
Senate President Pam Jochum, D-Dubuque, said majority Democrats are interested in expanding Medicaid coverage in Iowa and plan to hold another meeting Feb. 25 before moving the bill to the full Senate Commerce Committee.
Subcommittee member Sen. Nancy Boettger, R-Harlan, said she was torn between the needs of people and the uncertainty of expanding a partnership with the federal government given its staggering financial problems.
“There are a lot of sad stories out there and I’m not sure I know what the answer is. Can the federal government really pay for Medicaid expansion? It seems like they’re in a lot of trouble, and yet these are heart-wrenching stories. These are real people, real Iowans that have bumped into situations in life that are extremely difficult,” she said.
Branstad said funding decisions that play out in Washington, D.C., in the coming months will create a clearer picture of the federal government’s ability to make good on its financial commitments.“I feel my responsibility is to the people of Iowa and I want to get as much answered as possible,” the governor said. “I think we’ll probably know in the next few months how much of a cut we’re going to see from the federal government. I have grave concerns. When they say they’re going to take over the full cost of this, they haven’t fulfilled their promises in the past and I have no reason to believe that they can possibly afford to in the future.”