Branstad’s dismissal of Medicaid concerns flunks history

Gov. Terry Branstad is deploying revisionist history to defend his Medicaid privatization drive.

Earlier this week, the governor faced questions about the multiple controversies swirling around his effort to hand the state's $4.2 billion health insurance program over to four private firms. Recipients, families and providers have expressed serious reservations about the speed of the transition. Questions about the fairness of the bidding process have been raised. The Iowa Hospital Association has asked a Polk County judge to step in, while federal officials have expressed concerns.

He compared it to 2013, when lawmakers hammered out the Iowa Health and Wellness plan, a bipartisan health coverage expansion effort. Branstad, who signed it into law, claims that hospitals and other providers were 'up in arms” and opposed the compromise. Now, it covers 150,000 Iowans.

'I know there are people that want to protect their funding stream and are afraid of change, but the truth is this has proven to be effective in other states at improving medical outcomes. That's what we want to do,” Branstad said.

Branstad is leaving out many details. In 2012, he flatly opposed expanding Medicaid under the Affordable Care Act. The governor, like many Republican leaders, figured the law would be tossed out by the Supreme Court, or repealed by President Mitt Romney. Neither happened, and by the time legal and political scenarios played out, Iowa was left without its own health care expansion plan.

In early 2013, Branstad proposed modestly tweaking Iowa Care, a flawed program that was about to be discontinued, covering about 70,000 poor Iowans ineligible for Medicaid. His plan was opposed by providers and legislative Democrats, who favored more robust expansion under the AFA.

After months of political stalemate, Branstad finally accepted a legislative compromise creating the Iowa Health and Wellness plan in the final hours of the 2013 legislative session. And it was supported by hospitals and providers.

So a governor who resisted providing expanded health coverage, proposed an inadequate expansion plan and agreed to a better plan only after his position became politically untenable, now wonders why his unilateral decision to privatize Medicaid isn't being embraced. He blames fear of change. It's more likely discomfort with his record.

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