DES MOINES, Iowa — Gov. Terry Branstad's health care proposal for low-income Iowa residents received committee-level approval in the Republican-majority state House Monday, but the Democratic-controlled Senate instead favors a plan to expand Medicaid.
The House appropriations committee approved legislation for the "Healthy Iowa" plan in a party-line vote. The plan revamps an existing program for low-income residents and would provide coverage to an estimated 89,000 people with incomes at or below the poverty line using state and federal dollars.
Branstad opposes the Medicaid expansion permitted under President Barack Obama's health care overhaul, saying the long-terms costs are unsustainable. At the hearing Monday, Rep. Walt Rogers, R-Cedar Falls, said the Healthy Iowa plan would be a better option for the state.
"One of the reasons we felt it important for us to take this direction as a state is the fact that Medicaid is the fastest growing entitlement in our country," Rogers said.
But Democratic lawmakers argued that a Medicaid expansion would cover more people and cost the state less. Democrats pushed Rogers for details on the services provided by the Healthy Iowa plan.
"There are a lot of things we don't know," said Rep. Tyler Olson, D-Cedar Rapids. "There are three things we do know: This plan will cover fewer Iowans with fewer services at a greater cost to Iowa taxpayers."
The state cost for Healthy Iowa is estimated at $162 million per year, with the funding coming from the state general fund, local property taxes and other sources. The state would need to get a federal waiver to put the plan in place. Participants would be responsible for contributions, though they could seek to avoid those due to hardships.
The Senate has passed a bill that would expand the Medicaid program in Iowa. An expansion to include those with incomes up to 138 percent of the poverty level would add an estimated 110,000 to 180,000 to the state's Medicaid rolls. Under Obama's health care overhaul, the federal government would pay the full cost for the new enrollees during the first three years of the expansion and then 10 percent of the cost would gradually be shifted to the state.
The Healthy Iowa legislation will now move to the full House for debate.