Iowa Democrats continue Medicaid expansion push

DES MOINES – Senate Democrats on Thursday proposed a Medicaid expansion that would let the state back out if federal funding fell short, but it wasn’t clear whether the plan would overcome Republican Gov. Terry Branstad’s opposition to growing the program in Iowa.

The Democrats who control the Iowa Senate have been pushing to expand Medicaid, but the governor has expressed concern that the federal government doesn’t have the money to fulfill its promises. Senate President Pam Jochum, of Dubuque, called the latest proposal a compromise that would address Branstad’s concerns.

The Medicaid program that provides health care for financially needy children, families and disabled people in Iowa is run jointly by the state and federal governments. Under President Barack Obama’s health care overhaul, the federal government would pay the full cost for the new enrollees during the first three years of the expansion and then 10 percent of the cost would gradually be shifted to the state.

“The language we suggested would protect Iowa’s taxpayers from any risk and would address the governor’s concerns. In short, if the federal government’s sky falls, we’ll be off the hook as a state,” Jochum said.

Branstad says the cost of the program is unsustainable for the federal government and has questioned the long-term price tag for states. Asked about Iowa Democrats’ offer, spokesman Tim Albrecht said the governor will work with Democrats, but he continues to oppose an expansion.

Several other Republican governors have included similar caveats in their plans to accept funding for a Medicaid expansion. Arizona Gov. Jan Brewer and Ohio Gov. John Kasich both offered proposals with opt-out provisions.

About 400,000 people in Iowa are currently enrolled in Medicaid, with another 70,000 on a limited benefit program for low-income adults called IowaCare.