Gov. Terry Branstad isn’t giving up on his plan to make Iowa the healthiest state, even though his plan has been characterized as costing more and covering fewer Iowans than the alternative.
“Obviously we have a very partisan situation in the Legislature. A lot of people have their minds made up,” the GOP governor said at his Monday morning news conference.
However, Branstad said he believes there is time to make the case for his Healthy Iowa Plan before the Legislature’s schedule adjournment in four weeks.
Sen. Mary Jo Wilhelm, D-Cresco, who preciously has criticized Branstad’s opposition to Medicaid expansion, took to the Senate floor Monday to call the governor’s plan “no plan at all.”
His proposal is “packed with premiums, co-pays, other gotchas to deny working people health insurance,” Wilhelm said. The governor “wants working people who can’t afford ‘real’ insurance to pay for some kind of Branstad insurance lite.”
Branstad called on lawmakers to “get past the hyper-partisanship and try to come up with a practical plan that will meet the needs of this state for the long-term.”
His plan “is consistent with our Iowa philosophy of people taking ownership of their own health, but the state partnering and working with them.”
His alternative to a federally funded Medicaid expansion, House Study Bill 232, calls for the creation of personal rewards accounts for enrollees who could cut their $10 monthly premiums by making healthy choices, such as quitting smoking or regularly going to a gym.
It would cover people whose incomes are up to 100 percent of the federal poverty line, or roughly 89,000 uninsured Iowans. In addition to enrollee contributions, the plan would be paid for by general fund dollars and contributions from counties and hospitals. Funding would be about 58 percent federal and 42 percent state.
Estimates for the annual cost of the plan have fluctuated around $170 million. That’s more than the cost of expanding Medicaid to about 150,000 Iowans as part of the federal health care reform, according to Senate Democrats, who have vowed not to adjourn the session until Medicaid expansion is approved.
They cite data from the Iowa Hospital Association, which favors the federal plan. The Branstad plan spends county mental health dollars, Broadlawns Medical Center’s property tax levy, public funds from the University of Iowa Hospitals and Clinics and $23 million in general fund appropriations, the association said. Even then, the governor’s plan relies on about $225 million of matching federal Medicaid funds.
“In other words, the governor’s plan spends millions more of taxpayer dollars to provide health insurance coverage to fewer people than would be possible under Medicaid expansion,” according to the association.
Branstad seemed to write off the criticism of his plan as politics-as-usual. In the meantime, he said, he’s trying to get past “some of the unreasonable accusations and personal attacks.”“That is not the way we do business in Iowa,” Branstad said. “We are problem-solvers. At the end of the day, I’m hopeful the Legislature will recognize that as well.”