Democrats in the legislature say they’ve extended an “olive branch” to Republican Governor Terry Branstad in hopes that Branstad will reverse his opposition to extending government-paid health care coverage to up to 150,000 more Iowans. Senate President Pam Jochum, a Democrat from Dubuque, has been an advocate of expanding Medicaid cover Iowans she calls “the working poor.”
“These are not people trying to game the system,” she says. “They are working. They just happen to be working at jobs that pay low wages and have no benefits right now and we’re trying to help working poor Iowans get health insurance.”
The latest offer from Democrats would put an “opt out” provision in their proposal legislation, so the state could opt out if the federal government does not fulfill its promise to provide all the money to enroll more Iowans in Medicaid. Jochum says she’s confident that won’t happen.
“The federal government has never, never failed to meet its obligations to Medicaid in its nearly 50 years of existence,” Jochum says. “We believe that this is a step forward in trying to reach some kind of compromise with the governor in making sure that all Iowans have access to health care and affordable health care.”
A spokesman for the governor says Branstad is “pleased to see Senate Democrats are presenting an alternative approach.” Branstad communications director Tim Albrecht says while it’s a “first step,” this is no “grand bargain” that resolves the impasse.
Republicans like House Speaker Kraig Paulsen of Hiawatha are siding with the governor who is developing a different plan that would give about 80,000 Iowans a state subsidy to buy private insurance.
“The current Medicaid system is not a particularly efficient way to provide health care to any Iowans,” Paulsen says, “let alone low cost, you know, or low income Iowans.”
House Republican Leader Linda Upmeyer of Clear Lake disputes the idea putting more low income Iowans on Medicaid will reduce hospital charity care costs.
“To the extent that we can find an Iowa program that works for Iowans, creates quality, integrated care — that’s a far preferable way to go,” Upmeyer says.
Democrats say the governor’s plan that Upmeyer supports will cost state taxpayers more money and provide less coverage.