Iowa’s senators weighing new Obamacare plan

A last-minute attempt to replace the Affordable Care Act in the U.S. Senate has not yet won the endorsement of Iowa's two Republican senators, but the plan could be headed for a vote.

A new Republican bill, championed by Sen. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., has resurrected the battle over health care in Congress just weeks before the Nov. 1 enrollment period for coverage opens.

The legislation would revoke several parts of Obamacare, as the law is popularly known, such as the one requiring individuals to buy insurance. It also would take funding for its Medicaid expansion, premium tax credits and cost-sharing reduction payments and put them into a block grant to be sent to states. Iowa is among the states that expanded Medicaid under Obamacare.

So far, Iowa's two senators haven't said how they would vote.

'Senator Ernst is still going through and evaluating how this would impact Iowa,” her office said in an email.

In a statement, Grassley said Monday he, too, is still looking at the bill. But he said he likes that it 'returns power to states and individuals,” phases in changes and allows for alterations.

'We need alternatives to Obamacare, which hasn't worked,” he said.

Ernst and Grassley previously have voted for Republican-written Obamacare replacement plans. Those proposals failed to get the 50 votes needed in the Senate.

The nonpartisan Congressional Budget Office hasn't weighed in on the effects of the new plan yet. However, the Center on Budget and Policy Priorities, which has been critical of GOP plans, says taking the block grant and per capita provisions together, Iowa would lose $525 million in 2026. The organization said the bill would disrupt individual markets.

Iowa Gov. Kim Reynolds didn't pass judgment on the bill. But in a statement, her spokeswoman, Brenna Smith, pointed favorably to the 1990s-era block grant system that replaced the existing federal welfare program.

'If Congress pursues block grants, the governor believes they need to adequately fund them and provide maximum flexibility and control for states to sustain their Medicaid programs,” Smith said.

Since the major provisions of the Affordable Care Act kicked in, Iowa's rate of uninsured has been reduced by about half. However, for people who do not get subsidies or Medicaid, premiums have increased significantly. Just one company, Medica, has said it would be willing to sell policies in Iowa's marketplace next year and only with markedly higher premiums.