Still not a better deal than Medicaid

The Gazette Editorial Board

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There are things to like about Gov. Terry Branstad's Iowa Healthy Program, unveiled this week.

We appreciate the governor's ideas to curb costs while promoting healthy lifestyle choices - his plan would add some much-needed accountability to help rein in health care spending.

Branstad has repeatedly said he doesn't trust federal lawmakers to make good on their promise to fund Medicare expansion. He believes the Healthy Iowa Program will be more sustainable.

But as an alternative to federal Medicaid expansion, Branstad's proposal overall still appears to fall short - costing the state more money and leaving thousands more Iowans not covered.

The Healthy Iowa Plan, with some details yet to come, would cover about 89,000 uninsured Iowans earning less than the federal poverty level. It would replace IowaCare, the state program that provides limited health care coverage for Iowans who aren't otherwise eligible for Medicaid.

Branstad's plan would cover many services now covered under IowaCare. It also would cover prescription medication, something IowaCare does not, and expand patients' options for providers. Like IowaCare, but unlike Medicare, Branstad's plan as outlined Monday does not include coverage for mental health services.

The plan would require users to make some financial contribution toward their coverage or participate in a Healthy Behaviors Program. It would use a value-based reimbursement model to encourage quality care and better patient outcomes. All worthy improvements.

On the other hand, Medicaid expansion would add about 150,000 more Iowans to the federal program, with 100 percent of the cost covered for the first three years and at least 90 percent after that. If federal administrators approved Branstad's plan, only 60 percent of the program's costs would be covered by federal funding.

Branstad's plan to date has good ideas, but, bottom line, it offers less at more cost to the state.

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