A spokeswoman for Nebraska’s governor calls Iowa’s Medicaid expansion plan “unaffordable and unsustainable” and she predicts her boss will reject efforts in Nebraska’s unicameral to adopt the Iowa plan.

Iowa Governor Terry Branstad is among a few Republican governors who’ve accepted federal money to reduce the number of low-income Americans who are uninsured, but Iowa’s plan requires those who live above the poverty line to use a subsidy to buy private insurance rather than enrolling those individuals in Medicaid.

“We think this is a different plan,” Branstad says. “Other states like Tennessee and Pennsylvania and many others are looking at our plan and, obviously, each state has to make the decision they think makes the most sense for them.”

Branstad says he’s not bothered by critics like Nebraska’s governor or The Wall Street Journal who he charges do not grasp the “unique” approach Iowa is taking.

“Iowans I think understand what we’re doing,” Branstad says.

Branstad initially said he would oppose enrolling more people in Medicaid, but after a bipartisan breakthrough in the legislature Branstad approved a move to offer health care coverage to as many as 150-thousand uninsured Iowans, many of whom will get subsidies to buy private insurance. It requires a small monthly premium payment from those who fail to have yearly check-ups or follow a doctor’s orders to quit smoking or make other healthy lifestyle choices.  The federal government granted Iowa a waiver for the plan last week, but it forbids state officials from kicking people out of the program if they fail to pay the premium.