There’s been another statehouse breakthrough today. This one comes on a health are issue that had threatened to derail efforts to conclude the 2013 legislative session.

A tentative agreement has emerged that would use federal funds to provide government subsidies so low-income Iowans can buy private health insurance. Republican Governor Terry Branstad had resisted Democrats’ call to simply enroll up to 150,000 more Iowans in Medicaid. This new plan will be called Iowa Health and Wellness Plan and House Republican Leader Linda Upmeyer of Clear Lake is one of its architects.

“I’m really pleased with the outcome,” Upmeyer says. “Everybody moved their position a little bit in order to do the right thing by Iowans and the result is an Iowa solution for Iowans and I’m excited about that.”

Senate President Pam Jochum, a Democrat from Dubuque, is another legislator involved in the behind-the-scenes negotiations.

“We all really wanted to make sure that these 150,000 Iowans had health insurance,” Jochum says. “So there was a lot of give and take on both sites and at this point there’s a tentative agreement and we’re hoping that it becomes law.”

Nearly 90,000 Iowans who have an income that’s below the poverty line would get a government subsidy to buy into a health insurance plan just like those offered to state employees. Iowans who have an income that’s within 101 and 138 percent of the poverty line would get a subsidy, too, to buy a plan that’ll be offered on the new “insurance exchange” being set up in Iowa.  The state would accept federal money to cover those subsidies, something that had been a sticking point for Republicans who say the federal government can’t afford it.

Governor Branstad has repeatedly said he wants an “Iowa solution” that ensures participants have “skin in the game” and under this compromise those who fail to follow doctor’s orders for a healthier lifestyle — like giving up cigarettes — would have to start paying a part of their premiums in year two.

Radio Iowa