Feds back most of Iowa’s Medicaid expansion plan

DES MOINES – Federal authorities on Tuesday approved Iowa’s proposal to expand low-income health care, but they aren’t giving Gov. Terry Branstad as much flexibility as he sought to charge premiums on the very poor.

The announcement creates a political dilemma for the Republican governor, who has championed the use of premiums as a way to improve health outcomes in the state. Branstad did not immediately indicate Tuesday if he would accept the federal terms.

“I want to know the facts and see exactly what they’re talking about here,” said Branstad, who noted that lawmakers from both parties agreed to this plan in the spring. “I want to make sure what we do complies with the agreement we passed on a bipartisan basis with the Iowa Legislature.”

The state has 30 days to accept the terms, which would provide the state with full funding for the program in 2014, 2015 and 2016. Officials from the Centers for Medicare and Medicaid Service said Iowa’s request was granted with “virtually all the initiatives the state has proposed.”

“Iowa has pioneered innovative, state-based solutions for Medicaid expansion, and we are pleased to grant this waiver,” said CMS administrator Marilyn Tavenner in a news release. “CMS stands ready to work with other states to explore options that aim to improve care and lower costs in the Medicaid program.”

If officials can’t reach a deal, tens of thousands of Iowans will be impacted. More than 50,000 Iowa residents are already signed up for the Iowa Health and Wellness plan, all of whom are currently on a different low-income health program set to expire at the end of the year. Thousands more have applied for state coverage and may be eligible for this plan.

Iowa sought a waiver enabling the state to receive more federal Medicaid money for the proposed Iowa Health and Wellness Plan, a new health insurance program which would cover up to 150,000 residents not on the current Medicaid plan. The plan is scheduled to start providing coverage Jan. 1.