Refuting the Governor’s “true side-by-side comparison” on health care
Joint statement by Senators Jochum, Hatch, Ragan, and Bolkcom
“We welcome the fact that Governor Branstad is finally engaging in the health care debate.
“Yet the ‘true side-by-side comparison’ he issued today is a disappointment. Below is a factual rebuttal.
“At stake is health insurance for struggling working Iowans, lower health care costs for all Iowans, and the long-term strength and competitiveness of our state’s health care system.
“Based on public statements and private conversations, we are confident that the Iowa House and Senate will do what is necessary to move Iowa forward in this area.”
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Refuting the Governor’s “true side-by-side comparison” on health care
Governor’s document can be found here: http://tinyurl.com/br5gjan
Branstad Claim: “Iowans with below 100% FPL will be served by the Healthy Iowa Plan,…”
89,000 uninsured working Iowans making less than 100% of FPL would be covered under the Governor’s “Healthy Iowans Plan,” under the federal waiver the governor hopes to receive.
If the Governor receives such a waiver, Iowa will pay 40% of the cost while the fed pay 60%. Under Medicaid expansion, Iowa would pay at most 10% while the feds pay at least 90% after the 7th year. There is no state share for the first three years.
Branstad Claim: “…Iowans above 100% accessing health care through the affordable health benefits exchange.”
61,000 uninsured working Iowans who earn between 101 and 138 % of FPL would buy private insurance throughout the federal exchange. Each person covered in this way will cost the federal government up to $3000 more than if they were covered by Medicaid. To recover some of that extra expense, Iowa small businesses will penalized as much $19 million by the federal government.
Branstad Claim: “Rewards Quality Health Care Outcomes: Yes, in Year 1”
Everyone knows this claim is not true. The governor is talking about Accountable Care Organizations (ACO), a complex new approach to improving health care outcomes. There is only one ACO currently in Iowa, a pilot project located in Fort Dodge. There is no simply no realistic way for the Governor’s untried approach to implemented next year. Establishing working ACOs will take several years to accomplish.
The Senate plan for Medicaid expansion expands “medical homes,” the cost-effective coordination of a single patient’s care by medical and community support providers. The study referred to by the governor is the Senate’s responsible strategy of working with Iowa’s health care providers so the move to ACOs will be successful.
Branstad Claim: “Member Contributions: Yes, similar to the successful and popular Hawk-I program”
The Governor’s effort to rebrand insurance premiums as “member contributions” will be rejected by the federal government. Medicaid funds clearly cannot be used for premium-based insurance schemes for persons under 150 FPL.
In addition, charging struggling working people premiums for insurance results in denying them insurance. Under the Governor’s plan, Iowans who pay their rent, buy food, or make car payments and therefore miss a premium payment, will lose their insurance for a year. By failing to insure these people, the Governor’s plan will drive every other Iowan’s health costs.
Branstad Claim: “Estimated Cost to the State of Iowa at Full Implementation: Branstad Plan – $23 million”
Governor’s claim that his plan costs $23 million leaves out the following annual costs:
- $43 million in property taxes from every county in Iowa, an action which will likely torpedo the new mental health reform effort
- $42 million from Broadlawns Hospital
- $13 million from the University of Iowa Hospitals
- $42 million dollars in general fund money
Branstad Claim: “Estimated Cost to the State of Iowa at Full Implementation: Medicaid Expansion – $83.4 million”
The $89 million listed by the Governor is the estimated cost of for a FULL year of the Senate plan for Medicaid expansion in 2020, when the state share finally reaches 10%. For the first three years, the state share is 0%. After that, it increases to a maximum of 10% of 2020.
The true apples- to-apple cost of each plan in the first full year is $162 million for the governor’s plan and $5 million for the Senate Democratic plan. This $5 million is for administrative costs, no matter which plan is approved.
The true apples- to-apple cost of each plan in 2020 is difficult to determine. Since the Governor’s plan costs $162 million in 2014 and increases from there, the cost is certain to be more than the estimated $89 million cost of the Senate plan in 2020.
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