Branstad Takes Middle View On ACA

Iowa Gov. Terry Branstad has taken an unusual middle ground for implementing the Affordable Care Act in his state, promoting what he calls a hybrid approach working in conjunction with the federal government.

Branstad, a Republican, opposes many facets of the ACA, as do other GOP governors.

And to date, as many as 32 states may opt out of running their own exchanges, citing issues ranging from cost to the regulatory burdens.

However, instead of directly opting out of building an insurance exchange for the state's residents, Branstad said last week that he would reserve the option of working with the feds.

“I continue to have concerns that an intrusive federal exchange would raise costs on individuals and businesses, making it harder for them to create jobs and raise family incomes in Iowa,” Branstad said in a letter to U.S. Health and Human Services Secretary Kathleen Sebelius. “The State of Iowa intends to minimize the Federal government’s intrusion into the regulation of insurance. We will continue to regulate insurance plans in Iowa and retain control over our Medicaid and Children’s Health Insurance Plan eligibility.”

Branstad said he would explore either operating an exchange directly, or in tandem with the federal government, but would not cede the entire responsibility to the feds.

“Iowa is well positioned to meet the standards outlined by HHS thus far and maintain control of our insurance regulation and Medicaid eligibility responsibilities as allowed under PPACA,” Branstad wrote. “Iowa will partner with the Federal government in these areas of a federal exchange.”