Iowa Lt. Gov. Kim Reynolds predicted a troubled implementation of the federal health-care overhaul Monday, even raising the possibility the state could back away from the law as major provisions kick in at the beginning of next year.
Reynolds spoke to a meeting of the Scott County Republican Women, criticizing the Obama administration on a range of issues. But it was the health-care law, the Affordable Care Act, that drew questions from the audience.
Reynolds said the law has missed numerous deadlines and even though the state chose to pursue a model for its health-care exchange in partnership with the federal government, that could change.
"By choosing the partnership, down the road if they can’t make their obligations, then we still have an opportunity to pull back or to turn it all over to the federal government,” Reynolds said. “I don’t think they’re going to make it. I don’t think they’re going to make their targets. Everything that we’re seeing right now is they’re extending the deadlines, they’re pulling away from what their commitments have been. There’s just case after case where we’re already seeing that happen.”
Enrollment in health insurance marketplaces is scheduled to begin in October. However, conservatives have predicted havoc, and even some congressional Democrats are worried about the political impact if the rollout doesn’t go well.
In a brief interview after the event, Reynolds pointed to the delay in allowing small businesses to choose from a menu of insurance plans until 2015. "You're going to see more and more of that," she said. She added there also have been attempts in Congress to repeal the medical device tax that helps to pay for the law.
Iowa Sen. Jack Hatch, D-Des Moines, a chief proponent of the law in Iowa, responded that deadlines are mostly being met and Republicans who have fought against the law from the beginning are to blame for any delays.
He said the Branstad administration delayed deciding what kind of an exchange to form and resists expanding Medicaid, dragging its feet in even proposing an alternative.
“If there’s anyone who’s been missing deadlines, it’s the Branstad administration,” Hatch said. “The lieutenant governor is talking more about her wishful thinking about the federal government as opposed to what’s real.”
He said that since Republicans weren't able to kill the law in the U.S. Supreme Court or win last year's elections, they're now turning to its rollout.
Perhaps the biggest dispute is over whether to expand Medicaid to cover the uninsured who earn up to 138 percent of poverty, or $15,856 for an individual and $26,951 per year for a family of three. That’s what Democrats want, and what had been envisioned in the health-care law. But the governor says it is too fiscally risky and has proposed expanding the Iowa Care program, which is due to expire at the end of the year.
The lieutenant governor said Monday negotiations over education reform and cutting commercial property taxes are progressing, but the differences over health care are tougher to bridge.