Branstad provides details for Medicaid alternative

DES MOINES – Details of Gov. Terry Branstad's Medicaid alternative hit the House floor Thursday in a 21-page bill that calls for the creation of personal rewards accounts and that would cost $23 million from the state general fund in its first year.

“This plan is a plan that incentivizes people to take ownership of their health,” said Rep. Walt Rogers, a Cedar Falls Republican who plans to have meetings on the legislation next week.

The bill, House File 232, contains language to make sure providers are within 30 minutes or 30 miles of enrollees. Those enrollees would pay at least $10 a month for health services and would not get services if their monthly payment is not met, according to the legislation.

There also is a hardship exemption allowing some enrollees to have that co-pay reduced.

Enrollees also could cut their premiums by making healthy choices, such as quitting smoking or regularly going to a gym.

Overall, the Healthy Iowa Plan will cover people whose incomes are up to 100 percent poverty, or roughly 89,000 uninsured Iowans.

The plan would be paid for by the enrollee contributions, the state general fund and contributions from counties and hospitals. Rogers said the total split would be roughly 58 percent federal and 42 percent state. Estimates for the annual cost of the plan have fluctuated around $170 million.

“The actual goal of the plan is to get to a place where (costs) get smaller, but I think it would be at least this much for the foreseeable future,” Rogers said.

Rogers stressed that the governor's proposal still has to go through the House Republican caucus where changes could be made. The Democratic-controlled Senate has so far insisted on expanding Medicaid as called for in the Patient Protection and Affordable Care Act.

If the legislation gets passed at the state level, it still would need a federal waiver from the U.S. Department of Health and Human Services to take effect.

“If they don't approve this plan, we would go back to the drawing board and take a second look,” Rogers said. “Again, this is not necessarily the plan that is going to pass out of the House. What we want to do is look at it and any ideas the Democrats might have.”