Branstad, Iowa legislators reach health-care expansion accord

"We want to embark on a new system that will truly revolutionize"

DES MOINES – Gov. Terry Branstad and legislative negotiators have hammered out a bipartisan agreement to use federal money to expand health-care coverage to needy Iowans by financing insurance premiums for participants who help manage their costs with healthy choices.

The newly named Iowa Health and Wellness Plan contains elements that meets the desires of legislative Democrats to cover Iowans who have yearly incomes of up to $15,300 by providing a premium subsidy paid for with federal funds and the Branstad-led GOP approach for Iowans earning less than $11,000 annually who will be eligible for the same benefits currently provided to state employees.

“It will be unique,” said Senate President Pam Jochum, D-Dubuque, who indicated the hybrid accord will be contingent on federal officials granting a waiver for the plan that is slated to take effect in January 2014.

“We feel very good about this,” said Branstad, who earlier this week signaled a willingness to accept federal funds to expand health care to low-income Iowans provided there was an “opt-out” option to protect Iowa taxpayers should the federal government fail to make good on its pledge to pay 100 percent of the expansion’s cost for the first three years.

“We didn’t want to just stick with the old Medicaid system that hasn’t improved the health of Iowans,” the governor said Wednesday. “Instead, we want to embark on a new system that will truly revolutionize, where people will have ownership in their own help and we can improve the health of our citizens. This will put Iowa in the leadership position in the entire country in terms of doing this.”

Wednesday’s tentative agreement helped resolve one of the 2013 legislative session’s most-vexing issues that divided the governor, Republicans who control the Iowa House and Democrats who hold majority in the Iowa Senate even before the split-control General Assembly convened last January.

Under the hard-fought compromise, residents with income up to 100 percent of the federal poverty guideline would receive the same benefits as state employees with their insurance premiums being paid for entirely by federal Medicaid money, Jochum said.

For Iowans who have yearly income between 101 percent and 138 percent of the federal poverty standards, those residents will seek private coverage via the state-federal insurance exchange being formulated under provisions of the federal Affordable Care Act, she said.

The first year’s premium for those participants will be financed with federal dollars, and those premium subsidies will continue in subsequent years providing they receive yearly assessments and follow a doctor-directed health regimen, Jochum said. Those who fail to meet the objectives would have to pay a share of their future premium costs.

“There was a lot of give and take on both sides,” said Jochum, regarding the hybrid plan that was forged Tuesday evening with the guidance of House Majority Leader Linda Upmeyer, R-Garner, and Sen. Amanda Ragan, D-Mason City, in “opening the door” to the agreement that will allow participants to access services via their local providers.

“I'm really pleased with the outcome," said Upmeyer. "Everybody moved their position a little bit in order to do the right thing by Iowans, and the result is an Iowa solution for Iowans and I'm excited about that."

Provisions of the Iowa Health and Wellness Plan were included in the fiscal 2014 health & human services budget that legislators were slated to debate on Wednesday.

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