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Open letter to Gov. Branstad regarding Medicaid Expansion

Published: Tuesday, April 16, 2013 12:09 p.m. CST • Updated: Tuesday, April 16, 2013 12:11 p.m. CST

Dear Gov. Branstad:

The importance of providing qualified individuals with Medicaid has never been more important, especially since the Affordable Care Act is now settled law and that states will be fully reimbursed for expanding Medicaid for the first three years and ninety percent for every year thereafter.  However, those who must rely on Iowa Care have a very difficult road ahead.

I have always had many doctors & been on many medications due to Bipolar, OCD & Addison’s disease. These stressors resulted in me needing to be admitted to the psychiatric ward dozens of times between the years of 1995 – 2005.  Working full time during those years was very stressful, but I was able to save some money in a 401K with a good health insurance plan. When I could no longer handle the stress of the job, I was let go.  Losing the health insurance was devastating as I had to resort to paying for COBRA Insurance for catastrophic coverage which was very expensive, depleting most of my hard-earned savings.  At this point I found out about Iowa Care which helped, but was certainly nothing compared to the insurance I once enjoyed.

To my surprise, Iowa Care required much of my time with little results. Since Iowa Care only allowed me to be seen at the University of Iowa Hospitals & Clinics, and I live in Dubuque, appointments needed to be made about two months in advance.  For those who didn’t have the privilege of a designated driver, the Clinic provided a van ride for you.  However, on the day of the appointment, one needed to be ready for the pick-up at 5:30 a.m.  Multiple stops were made along the way through small towns in remote areas filling up the van with more individuals who were in need of care. Riding with strangers was often uncomfortable especially when one never knew of the personality conflicts that arose.

It was 10 a.m. when the van arrived at the Clinic. Since most appointments weren’t scheduled until mid-afternoon, it was the patient’s responsibility to pay for lunch. After being seen by a doctor (usually one who lacked rapport with you), a return appt. was made. The van’s schedule was to pick up the patient’s at 5:30 p.m. If you weren’t ready for the departure (which occurred more frequently than you might think), it was not the driver’s responsibility to search the Hospital for you.  As a result, you had to find an alternative means to get yourself back home.  I arrived at my residence as late as 9:30 p.m. on several trips.

Since then, I was able to convince the judge with a lawyer after repeated denials that I qualified for disability. This decision enabled me to become eligible for Medicaid & Medicare. Through these programs, I was able to begin leading a healthy, balanced life with the support of many self-help systems offered by the community. I can now go to any hospital in the Dubuque area. Mental health care is covered under Medicaid but not under Iowa Care, which is crucial for those dealing with disabilities like I have. I can now work at part–time jobs & volunteer at many different organizations which give me the purpose that I once felt as a full-time employee.

Please do the right thing by taking advantage of the Affordable Care Act which will cover 150,000 Iowans under Medicaid. It will be mostly paid for with federal dollars that Iowans deserve to benefit from. This is in stark contrast to what you are proposing which will cost Iowan taxpayers more, cover fewer people and offer a more limited health insurance package. To date, I have not seen a better way to improve the health of Iowans than to expand health care coverage to those who otherwise cannot afford it.  Based on my experience, Medicaid expansion is the clear choice.


Paul J. Oberfoell


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