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Branstad's Medicaid knee-jerk
Our governor says Iowa will not bow to federal "blackmail" by expanding Medicaid to cover more Iowans, now that the U.S. Supreme Court has ruled that the fed can't make us do it.
And here I thought he said last week's ruling was "disastrous."
As blackmail goes, I've seen worse. Iowa would expand Medicaid to include an estimated 150,000 people with incomes below 133 percent of the poverty level, about $14,856 for a single person, and who aren't among people currently eligible - the elderly, disabled, children and pregnant women. Some of these folks, about 60,000, are covered by IowaCare, a more bare-bones health plan that expires in 2014. The rest are uninsured.
I'm betting a lot of them are poor, young and single. Wow. A political clout trifecta.
Unlike regular strenghth Medicaid, which gets about 60 percent of its funding from the feds, this expansion would be fully federally funded through 2017. And after that, it would be locked in at no less than 90 percent.
Gov. Terry Branstad said he doesn't like big mandates from on high. (Unless, of course, he's the one imposing them on local governments.) He also doesn't like it when the federal government spends borrowed money. (But if it goes for keeping rural post offices open or sustaining a fighter wing in Des Moines, he just might make an exception.)
He also doesn't trust the feds to come through with the money. But when Iowa mayors make the same argument about his property tax reform plans...meh. What do they know?
Branstad insists that if you want to see what might happen to Iowa, look at awful broke Illinois. Heck, look at Greece!
Iowa tax collections grew at nearly double original estimates last fiscal year, so don't go ordering the gyro of doom just yet.
And actually, if you're looking for a state that expanded Medicaid to cover single adults up to 133 percent of poverty, look no further than Massachusetts. And who helped make that happen? Branstad's candidate for president, that's who.
And yet, Branstad seems so concrete certain this is a horrible idea, even though there's so much we don't know.
The 150,000 is, once again, an estimate. The governor's office says it would cost $800 million to cover them. But, truth is, no one really knows exactly how much the coverage would cost because we don't really know who would sign up, according to Department of Human Services spokesman Roger Munns. It's possible state officials could dig in, hone that estimate and provide us with a clearer picture.
The Legislative Services Agency says moving people currently covered by IowaCare to Medicaid would save Iowa $50 million. I'd like to know more about that.
The governor says Iowa is working on a way to do this better. Sharing some details of that approach would be nice.
Oh, and how much does it cost to leave these people uninsured? And who pays for that?
And does the governor give a rip? After twice vetoing Earned Income tax Credit increases, I'm beginning to wonder whether Branstad is aware that struggling low-income people are also his constituents. They might like a little of his attention while they wait, patiently, for him to create 200,000 jobs and raise their incomes 25 percent.
My main point is, the governor's decision looks like a typical knee-jerk political call, rather than a thoughtful decision driven by anything resembling facts and data. I don't really think it's too much to ask for team Branstad to drill down a little deeper than "Obamacare! All Bad! Go away!"
Maybe it is a bad idea. Perhaps there are compelling reasons for Iowa to say no thanks. How about explaining them?
Democrats want to have a health summit. Ugh. But it might not be a bad idea to sit down and talk about this. It might provide Iowans with a chance to weigh this decision based on facts. Maybe that's why the governor says he doesn't want to do it.
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