Iowa Senate rejects Branstad's Medicaid alternative

House had approved Healthy Iowa plan Tuesday; issue likely heading to conference committee

Majority Democrats in the Iowa Senate refused Wednesday to approve a House-passed version of Gov. Terry Branstad's Healthy Iowa plan – likely sending the issue of expanding health care coverage for lower-income Iowans to a conference committee to resolve differences.

Senators voted on a 26-24 party-line verdict to reject Republicans’ alternative to an expansion of the existing Medicaid program that Democrats prefer.

The governor’s approach, approved Tuesday by the Iowa House 51-49, would provide health care coverage to an estimated 89,000 additional Iowans earning less than $11,000 annually. Democrats favor expanding Medicaid to an estimated 150,000 Iowans with yearly incomes of up to $15,300.

Senate President Pam Jochum, D-Dubuque, argued that both approaches promote wellness and prevention, but the state will pay about $650 million less over three years because the federal government will fund the expansion under the Affordable Care Act through 2016. She contended the governor’s plan would require a mix of federal, state and local funds along with “membership” premiums, co-pays and deductibles paid by Iowans who currently can’t afford insurance, or have jobs that don’t include a health-care benefit.

Sen. David Johnson, R-Ocheyedan, questioned the reliability of the federal government in meeting its future financial promises, and suggested there is a “third way” to help Iowans get healthier without just providing a “revolving door” government entitlement.

“We are not going to leave lower-income Iowans without health-care access,” Johnson said. “There is room for compromise, and that’s where we ought to go.”