Medicaid Expansion Unlikely in Iowa House, GOP Leaders Say
Medicaid expansion unlikely in Iowa House, GOP leaders say
12:23 PM, Feb 12, 2013 | by Jason Noble |
Expanding the Medicaid health-care program for Iowa’s poor is unlikely to advance in the Republican-led Iowa House, GOP leaders said Tuesday in a meeting with the Des Moines Register’s editorial board.
House Speaker Kraig Paulsen, R-Hiawatha, said his chamber likely would pursue the continuation of an expiring health program for low-income Iowans, but could not support the more further-reaching expansion to Medicaid envisioned by President Barack Obama’s Affordable Care Act.
“I don’t right now see a scenario where we do the Medicaid expansion as defined in the ACA,” Paulsen said.
The expansion could add an estimated 150,000 Iowans to the Medicaid rolls, extending health insurance to single individuals without children and those at slightly higher income levels.
The expiring program that Paulsen referenced as a potential focal point of legislative action on health care is the IowaCare program, which provides care to low-income individuals who don’t qualify for Medicaid but which has more limited access points – requiring, for instance, patients to travel to either Des Moines or Iowa City for specialty care. Funding for the program is due to expire later this year.
Extending it is on the Republican agenda, Paulsen said, and that extension could reach “a significant subset” of the Iowans would be included in an expansion of Medicaid.
“I think we’ll have that conversation, and try to make that system and the other Medicaid systems operate in a more effective fashion,” Paulsen said.
That view is basically in line with that of Gov. Terry Branstad, who has said Iowa should not expand Medicaid because of uncertainty over the federal government’s ability to subsidize the program over the long term. But it conflicts with that of the Senate’s Democratic majority, which is pushing hard to write the expansion into law.
As for the IowaCare extension, House Majority Leader Linda Upmeyer said a proposal was in the works and could come up for discussion soon.
The 45-minute meeting between the leaders and the editorial board took place in Paulsen’s office at the Capitol, and covered topics ranging from health care to tax policy to the death penalty and a possible increase to Iowa’s fuel tax.
On most of those issues, Paulsen and the others declined to forecast their legislative futures, noting that conversations are ongoing in the dynamic environment of the Capitol.
This year’s session – the third consecutive year in which control of the Legislature has been split between Republicans in the House and Democrats in the Senate – has been unusually deliberate and focused, Paulsen said.
“There is not the flurry of activity that the Legislature has in years past,” he said. “I think it’s very focused, forward movement and I think we’re on target to get some very significant things done.”
The primary areas of activities, the leaders said, are education reform, which has dominated the first month of the legislative proceedings, and property tax reform, which is on deck for discussion perhaps as early as next week.
Senate Minority Leader Bill Dix, R-Shell Rock, said the sharp focus was a result of the specific and focused demands lawmakers are hearing from Iowans in their districts.
“We’re going to look for those opportunities to advance issues that create those kind of opportunities for Iowans,” Dix said.