For years, Iowa has been at the bottom of the Medicaid reimbursement ladder. Now, the state has the opportunity to gain some extra funding from the federal government.
But there’s one obstacle and it’s a big one: Gov. Terry Branstad.
We think he’s wrong and should reconsider his position sooner than later.
Here’s the deal.
President Obama’s health care overhaul would provide funding to states that expand Medicaid. If the state buys in to the program, the eligibility limit would be raised to 138 percent of the poverty level, or about $15,400 annually for an individual.
In Iowa, that could amount to an additional 150,000 people added to the Medicaid rolls. The program currently provides benefits for about 400,000 Iowans.
One expert, Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities in Washington, D.C., said children and families would benefit along with individuals, and that the state’s spending will not increase as the federal government covers the plan’s costs in the initial years.
“Expanding Medicaid has a very serious benefit for children,” Solomon told an Iowa legislative panel. “When parents are covered, children are more likely to get covered, they’re more likely to get care.”
Medicaid expansion also had the support of some 50 groups that gathered at the Capitol recently to make what our Des Moines Bureau called “fiscal, health and moral arguments” for the proposal.
Kirk Norris, head of the Iowa Hospital Association, said expanding eligibility would be a “win-win if not a win-win-win” for state government, low-income Iowans and the Iowa business community. The hospital industry is understandably anxious to see the guidelines expanded as it is a major employer — providing a $6 billion impact on the state’s economy.
Norris said if the state doesn’t seize the opportunity to expand the program and “take back what Iowa has contributed, which is $2.3 billion over 10 years,” the gap in reimbursement widens even further.
Branstad, however, is having nothing of it because he believes raising Medicaid eligibility limits would be too costly and points out the state already is picking up an additional $57 million in Medicaid costs this year because of decisions at the federal level.
As for covering costs of the program if it were expanded, Branstad doubts the federal government can do what it’s promising because of its debt situation.
“The expansion of Medicaid without any attention to outcomes fails the very people Medicaid intends to serve: vulnerable Iowans,” he said.
He instead favors continuing the IowaCare program, a state- and federally funded plan that provides limited health coverage to low-income adults.
He also continues to stress that Iowans must take it upon themselves to become more healthy. Thus, his Healthiest State initiative and programs such as Blue Zones which encourage Iowans to improve their health through smart eating and living decisions.
We couldn’t agree more that Iowans should seize on opportunities afforded them to improve their health.
But expanding Medicaid to more Iowans and having the government cover the costs is too good of a deal to pass up. There’s no reason the state can’t have it both ways.
There is one more thing to consider (well, there are many, but this one sticks out): The IowaCare program Branstad favors expires at the end of the year and renewed funding could be denied by the federal government. Perhaps the governor is waiting to see what happens with that program.
However, we believe the prize that’s there for the grabbing is too valuable to wait.
We hope that this doesn’t become a strict party-line issue that ends up costing Iowa a golden opportunity.
Gov. Branstad should reconsider expanding Medicaid eligibility to boost the pitifully low reimbursement rate, help Iowa’s economy and, most important, give new assistance to 150,000 Iowans who would be newly eligible.