Is Branstad right to continue rejecting Medicaid expansion offer from federal officials?
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Iowans facing tough financial challenges packed a Senate subcommittee earlier this month 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.
Iowa Gov. 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.”
What do you think? Is Branstad right to continue rejecting the Medicaid expansion offer from federal officials?
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In the end, Branstad will cave. What he is doing is political. He must bolster his base with an election a year away. The base loves the red meat of rejecting any form of Democratically initiated proposals.
The argument that the government may not meets its financial obligations is so unsound it gives me pause in his leadership. If California, Florida, Ohio, New York and 20 other states are already on board with much larger populations do you really think the fiscal viablilty of the program is reliant upon Iowa with its 3 million population? Use some common sense.
Finally, the medical community is vastly and overwhemlingly behind this. Sure, you can cite a few politically blinded doctors here and there and use them to cover the truth of the masses of medical administrators and practitioners but it is indisuptable that a clear majority of medical personnell are behind this.
The forumula is real simple. Billions in “reimubursed” or “covered” medical expenses means less upaid bills, passing the medical buck to good customers, and fewer bankruptcies.
We are not Greece, comparing us to them is ignorant of finance and simplistic. The ACA may not be perfect, but it would be a fiscally sound decision for this state to embrace its ability to make our finances better. The Feds, by necessity, will balance their books. It wont be pretty but as usual, they will get it done much like a college student throws their paper together the night before its due. They are still going to graduate, but man they could be so much better.
“The feds, by necessity, will balance their books.” When has that been true? Maybe you meant the states. Whatever.
Expanding medicare because the federal govt. will pay the tab is very short sighted considering our debt and deficits. The governors current plan is laying the infastucture needed to provide better care to Iowas working poor. Those need to be put in place first with a few changes to Iowa care, then I think we could expand the program to include a more efficient way to help more Iowans.
Fiscal surplus less than 15 years ago.
Also, every year the feds “balance” their books. Deficit spending has been a fact of government for decades. No nation on earth has the capacity to generate revenue and pay bills like the USA. Our GDP is in excess of 17 trillion. Japan has functioned, albeit not thrived, for 30 years with a 200% debt to gdp ratio.
So….when has that been true? Every year for decades. And more to the point you mean without really knowing what you mean, we had a yearly surplus less than 15 years ago without having to borrow to meet it.
So Jason it can be done, it has been done, and it could be done. Is that what you mean without knowing what you mean?
Rick Scott, the governor of Florida, adamantly opposed expanding medicaid under the ACA. At one time, he spoke out strongly against it. Now he has changed his mind and is doing what is best for the poorer people of Florida.
I assume/hope that Branstad will also come to his senses. However, I don’t think Branstad considers the poorer people in Iowa as his constituents.
How does FL have anything to do with IA? What all are you going to give up to pay for this?
Abernathy,
What can we give up to pay for this?
How about unnecessary emergency room visits by uninsured sick and injured people that the emergency room is required, by law to care for. The fewer of these we have the fewer of these unpaid bills get passed on to those who can pay.
How about work productivity lost to untreated illnesses and injuries
How about disability resulting from untreated illnesses andf injuries
How about all the collateral damage resulting from unnecessary death and disability due to lack of medical care.
I think we can easily give up all of that. The savings should at least be a wash
Florida does not have a state income tax. Governor Scott is only choosing to let the rest of us pay for his state instead of instituting a state tax.
And Branstad is doing exactly that Sue. He is letting us pay for Florida’s use. Too bad we won’t be using our share of federal money here in Iowa instaed of giving it away.
Bill, I never said it would be affordable!
Kettleson,
Based on what you posted, I have to assume that you think Floridians pay no state staxes.
Florida may not have an individual income tax, but it does have a corporate income tax. Sales tax is between 6% and 7.5 depending on which county you live in. Property taxes are among the highest in the nation.
Florida median income in 2011 was $44,300; percapita $24,900. Florida ranks 37th in terms of median income.
Florida has lots of poor people and lots of old people. In other words, lots of people with higher than average medical needs and and a very large hospital industrial complex. Politically mobilized old people combined with politically mobilized hospitals et al is a deadly combination for any politician.
Iowa has lots of old people and politically powerful medical and insurance industries. Branstad should take note
I think the question is how do we pay for the increase once Iowa is required to pay 40% of the cost like they currently do under Medicaid.
The federal government only included additional funds to pay for it through the next 7 years. Iowa already spends $6 billion a year on Medicaid(60% from fed) I am not sure we can afford more.
There is nothing in the law that calls for Iowa to pay for more than 10% of the cost of this expansion of Medicaid ever.
Thanks for the laugh. Ha ha ha ha.
Show me where in the ACA bill there is a provision to continue paying the 90% after the initial term expires in 2019 or 2020.
I will help you out, it is not there. Reason being is they needed the bill to be deficit neutral so it was not included.
No, Branstad is wrong.
I am flabbergasted that the Hospital Industrial Complex of Iowa hasn’t chewed up Branstad and spit him out by now.
Apparently that’s what happened to Rick Scott in Florida. So I’m waiting
What Branstad is doing is stupid no matter how it is looked at or who does the looking. Further, to argue that a limited HMO like IowaCare is an adequate replacement is just dumb
Branstad is despicable. Let people die in the street and then we will not have to listen to the conservatives whining about sharing until they want someone to protect them.
Owens,
While I agree that Branstad is despicable, he’s not exactly letting people die in the streets. What the deal is here is that Branstad thinks that Iowa can adequately care for its indigent citizens through IowaCare.
IowaCare dates back to 1911. It’s basically the old State Papers program updated to an HMO. It is, as far as I know, 100% state funded.
IowaCare collapsed when, because of the Recession, more Iowans lost their jobs and their health insurance and overburdened the system. It’s being revamped, but if Iowa is serious about providing care for all who need it, IowaCare is not the way to go. If we can’t afford 10% of the cost of Medicaid, then we sure as hell can’t afford 100% of the cost of IowaCare
Unless we cap the number of enrollees—which, I believe, IowaCare currently does—in order to stay within budget.
But then what happens to all those people who don’t make it into the system in time?