Senate Democrats offer compromise on affordable health care

Iowa Senate Democrats offer a compromise in order to insure tens of thousands of Iowans.  To address Governor Branstad’s concerns that the federal government will not keep its promises, Democrats offer to include a opt-out provision.  This has been done by other Republican governors who support Medicaid expansion.  Speakers: Sentor Amanda Ragan, Senate President Pam Jochum, and Senator Jack Hatch.  Recorded March 14, 2013.

Healthcare Bottom Line document, discussed below (PDF)

Remarks by Senator Ragan:

Hello, I’m Amanda Ragan. I’m the State Senator from Mason City, and I chair the Human Recourses Committee and I have since 2006.

Governor Branstad is really right to focus on wellness and prevention.  As he points out, helping people stay healthy is the best and most cost-effective way that we can provide health care.

The most important benefit in having health insurance is having an on-going relationship with your provider.

That is the core of the new health care opportunities Iowa has right now. And we can move further away from fee-for-service.  We can move even more in the direction of paying health care providers to keep people healthy, rather than just responding for people are ill or sick.

That’s why the Governor’s plan and staff put together with the Governor’s ideas. We accepted some of those and we had the first meeting on Senate File 71.

We adopted many of those things.  We took the innovation grant language and made it part of our bill.

We believe in the integrated care system, and we agree with him in moving with outcome-based Medicare is the way to go.

Remarks by Senate President Pam Jochum:

Good morning, I’m Pam Jochum

And yesterday Senator Hatch, Ragan, myself, and Senator Bolkcom met with the Governor’s staff and we offered a compromise to address his biggest concern with Medicaid expansion and that is the long-term reliability of federal funding.

Following the lead of other Republican governors in other states, we have offered to re-evaluate Iowa’s participation in Medicaid expansion if the federal government does not keep its promise.

In other words if it would renege on its commitment of paying  100 percent of the cost for the next three years and then of course it’s on a sliding scale that by 2020 it’s 90 percent participation  by the federal government and 10 percent participation by the state government.

The language we suggested would protect Iowa taxpayers from any risk, and it would address the Governor’s concerns.

In short, if the federal government’s sky falls, WE will be off the hook as a state.

I want to mention, and we should all remember, that the federal government has never, never failed to meet its obligations to Medicaid in nearly its 50 years of existence.

We believe that this is a step forward in trying to reach some kind of compromise with the Governor on making sure that all Iowans have affordable healthcare and access to healthcare.

Remarks by Senator Jack Hatch

 Healthcare Bottom Line document, discussed by Senator Hatch (PDF)

Good Morning. I’m Jack Hatch and I’ve been working with Senators Bolkcom, Ragan, and Jochum on working through our process of trying to get a proposal that is best for Iowa.

Recently we’ve  been working with the Governor’s staff and I think you have a comparison in front of you of our two plans, the Senate proposal and his proposal.

It seems like we’re agreeing with the governor a lot. I’m here to tell you that there is a significant part of his proposal that we cannot agree with, and that’s first his funding and that’s what we want to talk about today.

His structure of financing his proposal is a huge obligation of state dollars of $163 million dollars a year. He is asking that we remain under the old 60/40 plan, and that the state taxpayers incorporate and invest $163 million dollars to fund Medicaid expansion.

That doesn’t do as well, provides fewer services to fewer people and costs us $163 million dollars a year.

It’s important to know that this is a hit on Iowa taxpayers.

It’s a hit we don’t have to take because the Senate plan fully excepts the federal investment in Medicaid Expansion, and if you look at the bottom of your sheet we gave you there is a very significant irony in his plan.

He asks for $224 million dollars in federal dollars to match the $163 million that he is proposing. The difference is that under Medicaid expansion through the budget reconciliation plan of 2010 the federal governments contribution to states is already obligated and is already part of the deficit reduction figures that we’re hearing about in Washington.

Under the Governor’s plan he’s actually asking the federal government to appropriate new money $224 million dollars that is not covered under the reconciliation plan.

So he is actually adding to the federal debt and the very program and the very criticism that he says he wants to avoid. It’s a strange phenomenon. One in which we realize that his people have to work a little harder in understanding the law.

Now there is another part of this plan that he’s cobbled together state and local money that is also disturbing to a lot of us and should be disturbing to Republicans who have worked so hard on mental health.

Mental health redesign the past three years has focused not only on a regional basis but how the state and the local counties fund mental health services in his plan you will notice that he is asking for $44 million dollars in mental health property taxes to fund part of the state’s share.

Which means he has to go out to each of the 99 counties get an agreement with all of the supervisors to literally scoop that money back to pay for the Medicaid services under his plan, which would lower the available local money for counties to fund other mental health services that we have been working so hard to protect.

His plan doesn’t make sense at all on the local level at the state level and purposely it is a plan that will take Iowa tax payers away from the state and possibly away from taxpayers who could who know why there giving taxes to state and expect us to spend it reasonably.

In the end his proposal is unaffordable, unsustainable, and unworkable.


Posted Mar. 14th, 2013 at 12:06 pm by