Gov. Terry Branstad brought home evidence of how far the Obama administration will and won't bend to get more states to expand Medicaid
coverage to the levels called for in the healthcare reform law
The state will extend health coverage to as many as 100,000 residents next year under a waiver that allows the state to use federal funding to buy coverage for adults earning up to 138% of the federal poverty level through the state's federally operated insurance exchange.
The waiver also includes initiatives aimed at encouraging healthy behaviors and permission to impose premiums on some of the new beneficiaries if they decline to participate. The premiums, equaling as much as 2% of their annual income, can be charged to beneficiaries making more than the federal poverty level ($23,550 for a family of four).
Branstad, who had asked for permission to apply the premiums to those making as little as 50% of the poverty level, agreed to move forward with the plan as approved by the Obama administration, though he said some details still have to be worked out.
Joan Alker, executive director of the Georgetown Center for Children and Families, said there is evidence that premiums deter low-income people from enrolling. The Obama administration's willingness to allow even the more limited premiums, Alker said, shows it's serious about its overtures promising to be flexible with states and bodes well for a similar waiver application submitted by Pennsylvania.Follow Virgil Dickson on Twitter: @MHVDickson