DES MOINES | Gov. Terry Branstad said Tuesday he will move ahead with plans to request a federal waiver to broaden the IowaCare program rather than expand Medicaid coverage to another 150,000 Iowans.
Branstad, who met with U.S. Secretary of Health and Human Services Kathleen Sebelius recently, said he is optimistic the state can crate a health care delivery system for Iowans that will meet their needs while containing costs. The program serves more than 60,000 low-income Iowans
"We do intend in the near future to submit our proposal for renewing and improving and changing our IowaCare program," he said.
Branstad said Iowa's Medicaid program would include incentives for members to focus on prevention and personal responsibility in their health decisions.
"Just expanding Medicaid has not worked to improve health. In fact the health of the American people has gone consistently downhill," he said. "We've become more obese and less healthy."
Branstad said health care reform must increase the quality of care, lower costs and make Iowans healthier. He said that Iowa Medicaid has grown from 250,000 recipients in 2000 to more than 400,000 Iowa adults now served -- an expansion that grew participation by 65 percent and increased costs by 129 percent to more than $3.7 billion projected for fiscal 2014.
The IowaCare waiver program would cover Iowans below 100 percent of the federal poverty level and would require monthly contributions co-pays and deductibles which could be waived if preventative services are completed. The mechanisms are not intended to create financial savings for the state, but rather to encourage health and cost-conscious behaviors.
Critics of IowaCare -- a state and federally funded plan that provides limited health coverage to low-income adults from ages 19 through 64 who are not otherwise eligible for Medicaid -- say the program costs the state more, covers fewer Iowans, and provides fewer services than Medicaid expansion.
The Senate's Human Resources Committee on Wednesday is scheduled to consider legislation to expand Medicaid coverage to another 150,000 Iowa residents. Backers say the measure will aid needy Iowans who have no health insurance or are inadequately served by IowaCare and other options.
Starting Jan. 1, 2014, the new federal law expands Medicaid eligibility to people making up to 138 percent of the federal poverty line, or about $15,400 for an individual. Under the law, the federal government will pay the full cost of the expansion the first three years; thereafter, the federal share gradually phases down to 90 percent.