March 28, 2024

Ending IowaCare without Medicaid expansion will hurt Iowa hospitals

To the editor:

Until recently, Gov. Terry Branstad failed to start working on any low income health system, knowing that Iowa had three years to develop improvements to IowaCare or to set guidelines for expanded Medicare.

He just hired two companies for a meager $40,118 to expand IowaCare. It seems like a big task to complete in the two months left in this legislative session.

It would behelpful to put up this new system, the Healthy Iowa Plan, on a website that compares it with the current IowaCare and Medicaid systems, including costs and where the funding for this new system would be raised.  In 2012, IowaCare expenditures were $162.1 million, according to www.ime.state.ia.us/IowaCare/. 

Currently, IowaCare is funded by 59 percent by the federal government, 5.4 percent by the state’s General Fund, and the remainder from a combination of sources, including Polk County tax revenue and certified public expenditures by the University of Iowa Hospitals & Clinics.

If instead Iowa signed up for expanded Medicaid, it would be funded entirely by the federal government, phased down to 90 percent by 2020, according to www.healthcare.gov .

The Code of Iowa eliminates the IowaCare program Oct. 31, 2013, and the federal government’s approval of the Healthy Iowa Plan is required to extend any waiver from enrolling in expanded Medicaid. It is on the back of Iowa lawmakers to meet the legal requirements.

Judging by Gov. Branstad’s past snubbing of low-income Iowans’ access to health insurance, as well as the law that governs it, the odds are not in Iowa’s favor. Discontinuing IowaCare without qualifying for some level of Medicaid expansion will result in large increases in uncompensated care in Iowa hospitals.

Julie Stewart Ziesman

Waukee