Iowa formally seeks health-care innovation waiver

DES MOINES – Gov. Terry Branstad and Lt. Gov. Kim Reynolds formally requested a federal waiver Friday for a bipartisan Iowa Health and Wellness Plan that proponents say will reward Iowans for taking responsibility for their own health.

“We write to request expedited approval,” Branstad and Reynolds said in a letter to President Obama and U.S. Health and Human Services Secretary Kathleen Sebelius seeking waivers for federal approval.

“Our plan passed with bipartisan support and is designed to increase access, drive personal health ownership, and reform our health care delivery system to pay for quality, not quantity of health care delivered,” according to the joint letter.

The GOP governor and Iowa's split-control Legislature hammered out a bipartisan pact last May that seeks 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. Backers say about 150,000 more Iowans will be eligible for health care at a reasonable cost via the legislation, which can't take effect without a waiver from the federal government.

“The successful implementation of the IHWP is now in your hands,” Branstad and Reynolds said in their joint letter.

“We want to be innovative and implement a program that improves the health of Iowans. We have been encouraged by our success in working with HHS, but our current Iowa Care waiver expires at the end of this year. Replacing the expiring Iowa Care program with the modern Iowa Health and Wellness Plan is of paramount importance to our state and our citizens,” they added.

“Any delays in approval may severely disrupt the coverage of many Iowans,” said Branstad and Reynolds, who offered to discuss the waiver request when they are in Washington D.C. next month or to talk by phone if the Sept. 24-25 time frame would not work.

The newly named Iowa Health and Wellness Plan contains elements that met 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. The plan included an “opt-out” provision 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.

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.

Iowans who have yearly income between 101 percent and 138 percent of the federal poverty standards will seek private coverage via the state-federal insurance exchange being established under provisions of the federal Affordable Care Act.

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