OTTUMWA — While neither side got the health care plan they designed, the proposal they ended up with is not too bad, said two area legislators from different parties.
"It is different, that's true," said state Sen. Ken Rosenboom, R-Oskaloosaa. "It’s a hybrid is the term some people were using in Des Moines. A compromise. But I feel it's a very workable, reasonable compromise."
"I’m just really thankful the leadership worked on this that whole weekend," said state Representative Mary Gaskill, D-Ottumwa. "I was fearful we wouldn’t get it through the federal government. But this one has a chance, and if there are any issues, they might be minor enough we can work them out."
An example of the concern state lawmakers have: The federal government does not allow monthly premiums to be charged when people are on specific low-income health-care programs. To be fair, though, added Gaskill, the final rules are not yet in place. While there has been a vote, it will be up to the Iowa Department of Human Services to determine exactly how the new plan gets implemented.
But the "big questions" have already been answered.
"If you break down the two sides in the debate, [this] was the piece of the equation the Republicans felt was missing: They wanted responsibility included," said Rosenboom. "The governor wanted — and I agreed — there must be some accountability. People must have some ownership over their own health."
"I understand the Republicans and the governor, that people do need to be more responsible for their health," said Gaskill. "Obesity and smoking tend to cause health problems."
"If you can live any [unhealthy] lifestyle you want, then send someone else the medical bill for the consequences, that doesn’t seem reasonable to me," Rosenboom said.
Rosenboom and Gaskill explained if low-income Iowans who qualify for the new health care act do what's best for their health — smoking cessation classes, nutritional education, an annual physical — their premium will be waived.
There is an expansion of Medicaid, but it's not as wide-ranging as Democrats had originally asked for.
Before the rules are finalized, the public will have a chance for input. The state is scheduling public hearings. Gaskill said those meetings are planned for larger cities but that residents can always submit comments in writing. To see whether the new act is acceptable to the federal government, the new law, as well as public comment, is sent to Washington and reviewed.
"We will have a plan," said Gaskill. "It may not be exactly what we had. But 150,000 low-income uninsured Iowans will have health insurance."