Republican Governor Terry Branstad isn’t ready to celebrate the waiver federal officials have granted the State of Iowa for a plan to expand the number of low-income Iowans who qualify for government-paid Medicaid health care coverage.

The sticking point? Federal officials do will not allow the state to charge small monthly premiums to those who live at or below the poverty line.  Branstad this afternoon told reporters he needs more facts.

“We’ve had discussions with them that are inconsistent with that and we want to make sure that it’s clarified,” Branstad said. “…I want to see exactly what they’re talking about here and I think we have to make sure that what we do, it complies with the agreement that we passed on a bipartisan basis in the Iowa legislature.”

Branstad has repeatedly said it’s important for people “to take ownership of their own health” and that’s why the threat of a premium is important. Under the plan as Branstad envisions it, the premium charge could be waived if the Medicaid recipient undergoes a health risk assessment and takes step to improve their health. The U.S. Department of Health and Human Services has ruled against the idea of charging premiums to those who live below the poverty line, which for an individual is a yearly income of about 11-thousand dollars. Branstad has 30 days to appeal that decision, but he’s not yet ready to say whether he’ll appeal.

“Doing the right thing is always difficult, especially when you have people that play politics,” Branstad said. “But our interest and our goal has always been to improve the health of Iowans and that’s what we’re going to continue to work for.”

U.S. Senator Tom Harkin, a Democrat, has weighed in on the federal government’s waiver decision, calling it a compromise in which neither side gets everything they want. Harkin said now is the time to “move forward and give thousands of Iowans guaranteed access to dependable health care for the first time.”

Up to 70,000 Iowans who’ve gotten health care coverage through a state/federal government program called “Iowa Cares” will lose that coverage on December 31 and if Branstad refuses the waiver, those Iowans will not be covered, plus up to 80,000 more who would have qualified for the Iowa Health and Wellness Plan will be in limbo as well.