Local legislators hope to reconcile two fundamentally different health-care proposals as the Legislature nears its final days in session.
This means taking Gov. Terry Branstad’s health proposal and somehow managing to create a hybrid with Senate Democrats’ proposed expansion of Medicaid.
“Senate Democrats are going to press like crazy to make sure we get something done [before we adjourn],” said Sen. Joe Bolkcom, D-Iowa City. “It’s hard for me to see a path to merging on the financial side.”
Like other states across the country, Iowa has the option to expand Medicaid under the Affordable Care Act.
Senate Democrats seized this opportunity March 25 by passing Medicaid expansion with a party line vote of 26-23, while the Iowa House — controlled by Republicans — has released more details of Branstad’s Healthy Iowa Plan.
Bolkcom joined other legislators at a forum on April 27 sponsored by the Johnson County League of Women Voters at the Iowa City Public Library, 123 S. Linn St. Some audience members were vocal in their push for Medicaid expansion, as Rep. Bobby Kaufmann, R-Wilton, voiced his concerns about Senate Democrats’ plans.
“The opposition to Medicaid expansion is not a part of some conspiratorial club that believes the government is going broke,” said Kaufmann, the lone Republican at the forum. “All I’m saying is if we’re going to expand Medicaid, that’s fine, but why not do a hybrid plan that combines the best of both and just be cognizant that after three years — there’s no conspiracy here — they have done it for the last 10 years, they are going to take some of the dollars back in the blended rate.”
Kaufmann said that while he is “not a blind follower” of the Healthy Iowa plan, he believes the concerns over the government changing the rate it reimburses the state make it an issue that needs to considered during the debate.
Bolkcom responded by pointing out other grants the state has received from the federal government — including a grant passed last week.
“I don’t hear anybody from the other side saying we cannot afford to do farm payments anymore,” he said. “Switch to Medicaid, when we’re getting ready to provide health care to low-income working people — we can’t afford this, we can’t depend on it.”
Both plans would try to replace IowaCare, which currently serves uninsured Iowans who cannot get Medicaid. IowaCare is set to expire at the end of this year, and representatives from both parties want to replace it.
One political expert said a compromise between the two sides could be possible at this point, but Iowa has a different position on the issue then other states.
“Other Republican governors have gone with Medicaid expansion, because that is the best their state can afford,” said Tim Hagle, an associate professor of political science at the University of Iowa. “Iowa is in a better financial position with the surplus, and the surplus is something that could help fund the governor’s plan.”