Reynolds: We need health reform with flexibility

By Erin Murphy, Gazette-Lee Des Moines Bureau

DES MOINES - Gov. Kim Reynolds said Monday she is monitoring Congress as lawmakers draft legislation that would make sweeping changes to federal health care policy.

The GOP governor said she believes federal action is needed because health care reforms made under former President Barack Obama, a Democrat, are 'collapsing,” and she is hopeful the Republican-led effort would give states the flexibility to use federal funding to craft their own programs.

The state recently petitioned federal regulators for permission to divert $352 million in anticipated federal funding for 2018 to a restructured system of premium tax credits and a state-run high-risk pool.

At the time, Iowa was facing the possibility of becoming the first state in the country without at least one health insurance company selling federally-approved plans on the statewide exchange. Minnesota-based Medica since has said it will continue to sell, but with an average premium increase of 43.5 percent a month.

'Probably one of the biggest things that (Congress) could do, and that's in our stopgap proposal, is to give us some flexibility in how we design the program,” Reynolds said. 'Because we know what Iowans need. I don't know what Colorado needs. I don't know what North Dakota needs. But I know the health insurance environment in Iowa.”

The Republican proposals - the House passed its version and the Senate is working on a similar bill - would undo many of the reforms passed by Democrats in 2010. The GOP proposals would remove the requirement that all individuals purchase health insurance, alter the federal subsidies designed to help low-income residents purchase insurance, soften the requirement that all patients be eligible for coverage regardless of pre-existing conditions, and reduce federal funding for Medicaid, among other provisions.

The nonpartisan Congressional Budget Office projected that if the House or Senate bill were to be implemented, more than 20 million people would become uninsured over the next 10 years, either due to lack of access or by choice.

The proposals have been unpopular with health care advocacy groups and the public.

Only 3 out of 10 people said they find the Republicans' health care plan favorable, while more than half said they find it unfavorable, according to national polling by the Kaiser Family Foundation, a nonprofit, nonpartisan health care policy think tank.

Health care industry and advocacy groups like the American Medical Association and AARP are among the dozens that oppose it.

If thousands of Iowans lose health care through GOP reforms, Reynolds said there are other ways to help them.

'There's a lot of different ways that we can work with vulnerable Iowans. It starts with helping them get the skills that they need to fill the jobs that are available today. There's a means of providing a safety net as they get the skills that they need,” she said. 'I think the more that we holistically can look at how we meet the needs for those individuals, but most importantly help them succeed and help them have a great quality of life, but making sure that there's some type of a safety net there along the way - so we're not ripping that out from underneath them, but phasing it out while providing them options to get a great job and have a great quality of life. I guess that's what I'm looking for.”