Iowa Reaches Deal on ACA Coverage Expansion
Iowa is moving significantly closer to expanding healthcare coverage for the poor as part of the Affordable Care Act, with its lawmakers passing compromise legislation late last month that would insure tens of thousands of low-income residents without enrolling them in Medicaid.
The bill creates the Iowa Health and Wellness Plan. Under its operation, those individuals and families with incomes of up to 100% of the federal poverty level would receive the same coverage as state employees. Those with incomes up to 138% of poverty would receive subsidies to buy coverage on Iowa's health insurance exchange. They would also be subjected to annual wellness measurements and may be charged small premiums if they don't comply.
Altogether, about 150,000 Iowans would be covered. Gov. Terry Branstad recently signed the bill into law.
The bill covers an identical number Iowans who would have qualified under a full expansion of Medicaid while reassuring Republican lawmakers who were opposed to such a large-scale expansion because they doubted the federal government would continue funding the Medicaid expansion as promised. Under the Affordable Care Act, the federal government would pay 100% of Medicaid expansion during the first three years, and 90% in subsequent years.
Since the coverage and subsidies would be paid for with federal funds anyway, the plan requires a waiver from the Centers for Medicare and Medicaid Services. Lawmakers are mostly optimistic that it will get the go-ahead.
“(CMS has) indicated more flexibility in the past month or so, because they really do want every American to have health insurance,” said Senate President Pam Jochum, a Democrat who represents Dubuque.
About half of the states so far have resisted expanding their Medicaid program, most either with GOP governors or GOP-controlled statehouses. Lawmakers in some Southern states, such as Texas and Louisiana, have refused to even discuss alternatives.
The Iowa Department of Human Services is expected to submit its waiver application to CMS by June 28.
