DES MOINES — Gov. Terry Branstad said he’ll talk about expanding health coverage in Iowa when he meets with U.S. Secretary of Health and Human Services Kathleen Sebelius in Washington, D.C., this weekend.
But the five-term Republican governor gave no indication that he plans on joining the states that have opted to expand Medicaid coverage as called for by the Patient Protection and Affordable Care Act.
The Medicaid expansion provision was ruled unconstitutional by the U.S. Supreme Court in a June 2012 decision that kept the other major components of the bill intact.
States have been given the option to opt-in to expanded Medicaid coverage under the federal guidelines with a promise that the federal government will reimburse most of the cost of expansion.
Branstad has been opposed to the idea, which has put him at odds with the state hospital association and the Senate Democrats. Instead, the governor said he’ll introduce a plan that expands the state’s IowaCare program.
“I don’t have all the details (of the plan) either, and there are still several options available,” Branstad said Monday. “Some people want to have a political fight over everything. My interest is to make Iowa the healthiest state in the country, and the way we’re going to accomplish that is to get Iowans to take ownership of their own health.”
According to the Advisory Board Company consulting firm, Iowa is one of 18 states that is either against or leaning against Medicaid expansion as of last week. Six states are undecided, and the remaining states are either for or leaning toward expansion.
Senate Democrats introduced legislation to expand Medicaid to all Iowans who are below 138 percent of the poverty level. That would add an estimated 150,000 people to the Medicaid rolls, according to Michael Bousselot, Branstad’s health care policy adviser. That’s on top of the more than 400,000 who already receive assistance through the program.
Branstad said he worries the federal government would not follow through on its promise to cover most of the cost of the expansion and states would be left holding the bag.
“Quite frankly, I think that’s a scare tactic,” Senate President Pam Jochum said during a taping of Iowa Public Radio’s “River to River” program Monday afternoon. “The federal government has come through with Medicaid dollars.”
She added that some states have put trigger measures in their laws that say if the federal government defaults on its payment obligation, the state can pull back on its expansion.