Iowa reaches compromise on Medicaid expansion

The Iowa Legislature has approved a bill expected to significantly expand coverage for the poor under the Affordable Care Act without dramatically growing the Medicaid rolls, the Des Moines Register reported.

Gov. Terry Branstad is expected to sign the compromise bill into the law, according to the story. It allows about 150,000 low-income Iowans to receive insurance through the Iowa Health and Wellness Plan. Those with incomes up to 100 percent of the federal poverty level would receive coverage equivalent to what state employees receive. Those with incomes up to 138 percent of the poverty level will receive subsidies to purchase coverage through the state's health exchange.

The bill covers the same amount of Iowans who would have qualified under a full expansion of Medicaid while mollifying Republican lawmakers who were opposed to such a large-scale expansion, according to the Register.

Whether such a compromise is adopted by other GOP-dominated states remains to be seen. In Utah, where lawmakers have yet to make a firm decision, a new report by the Public Consulting Group concludes that the state would save $131 million over the next decade if it expanded the Medicaid program, the Salt Lake City Tribune reported. However, if Utah doesn't expand Medicaid coverage, it could cost the state an additional $177 million, as publicity regarding the ACA will spur those eligible for coverage under the existing income guidelines to seek enrollment.

"My focus is the total cost to Utah's taxpayers--not just the state cost, not just the federal cost, not just economic modeling," Gov. Gary Herbert said, according to the Tribune.

To learn more:
- read the Des Moines Register article
- read the Salt Lake City Tribune article
- read the Public Consult Group report (.pdf)

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