Iowa Legislature health care negotiators hopeful of compromise

Key legislators and Gov. Terry Branstad expressed optimism Monday that progress was being made to forge a “hybrid” health care compromise that would merge elements of the governor's “Healthy Iowa” plan with Senate Democrats' desire to expand Medicaid to cover low-income, uninsured Iowans.

“If we're going to get something resolved, nobody's going to get their way totally,” the governor told reporters during his weekly news conference.

Branstad indicated he was "willing to consider" trying to merge the competing plans as long as Iowa taxpayers were protected in the process and certain “ownership” provisions were required of health care recipients to help improve outcomes and hold down costs.

Rep. Dave Heaton, R-Mount Pleasant, said Branstad's assurances signaled progress to him and Sen. Jack Hatch, D-Mount Pleasant, said he saw positive signs that the governor, Senate Democrats and House Republicans were “all now generally on the same page” – a development that could greatly accelerated prospects for compromise.

“I don't think we're that far off now that we're moving,” Hatch said. “We've kind of shed some of the old skin and I think there are some real opportunities for us now.”

Branstad's Healthy Iowa approach approved by the GOP-led Iowa House would provide health care coverage to an additional 89,000 Iowans earning less than $11,000 annually but would require some buy-in to promote healthy lifestyles, wellness and personal ownership. Legislative Democrats favor expanding Medicaid to an estimated 150,000 Iowans with yearly incomes of up to $15,300.

During his weekly news conference Monday, the governor said he believed he needed legislative approval to implement any further health care approach that would require a federal waiver but Hatch said his research indicated otherwise and he wanted an agreement on health care expansion and the fiscal 2014 health and human services budget before the 2013 regular session ends.

Heaton said the budget bill has to proceed because under-served Iowans rely on the $1.7 billion in state and federal appropriations tied to that measure. He had not ruled out the option of reconvening in special session, as Branstad has suggested, to resolve the health care expansion issue given that the deadlines for getting a federal waiver on his proposed Healthy Iowa expansion of the Iowa Care program doesn't arrive until later this year.