Iowa hospitals were key players in a last-minute “hybrid” deal to expand Medicaid, the second such legislatively approved deal in the country.
The Iowa Medicaid expansion compromise, dubbed the Iowa Health and Wellness Plan, passed the Legislature on May 23—its final day—and awaits the signature of Republican Gov. Terry Branstad.
The deal overcame a legislative impasse between Senate Democrats—who wanted a standard expansion to add more than 150,000 residents to the state's Medicaid program—and House Republicans and Branstad—who favored a smaller expansion of a more limited state-funded health program.
Branstad's objections to the standard expansion centered on concerns that the promised federal funding of 90% of the expansion's costs could disappear in the face of the federal government's budget woes. Under the Patient Protection and Affordable Care Act, the federal government from 2014-2017 will pay 100% of the costs for expanding Medicaid to all Americans under 138% of the federal poverty level. But each state must decide whether to go ahead with the expansion, the U.S. Supreme Court ruled last year.