The Iowa Chapter of the American College of Physicians has chosen to join with the Iowa Medical Society, the Iowa Hospital Association and other professional groups to advocate for Iowa to accept Medicaid expansion for our state as allowed in the Affordable Care Act. We are pleased that Gov. Branstad recognizes the need to expand health care coverage for financially struggling Iowans in proposing his Healthy Iowa Plan to replace the Iowa Cares program. However, the governor’s proposal will provide fewer benefits, cover fewer Iowans and cost Iowa taxpayers more than Medicaid expansion.
The governor appears to be singling out health care as an area where he is reluctant to accept federal dollars, since Iowa now receives $6.55 billion annually from the federal government for roads, education, job development, student aid and economic development among other programs. Gov. Branstad’s opposition to Medicaid is particularly puzzling because it will require federal subsidies and a federal Medicaid waiver for the governor to proceed with his alternative. We believe this wrongheaded opposition to the Medicaid expansion will hurt our patients, our hospitals, physicians and communities.
In addition, Gov. Branstad’s reliance on privatization, “healthy living initiatives” and out-of-pocket contributions would increase the complexity low-income Iowans must overcome to access health care coverage, and these hurdles are likely to reduce the health care improvement he envisions. Medicaid would provide simpler and more comprehensive access to health care for up to 150,000 of our fellow Iowans. Finally, Iowa already struggles to attract and retain physicians, a problem the governor recognizes and has endorsed programs to combat. The Healthy Iowa Plan will worsen health economics in Iowa, making it even less attractive to these professionals.
We urge Gov. Branstad to follow the example of his eight Republican gubernatorial colleagues who have reversed their positions on Medicaid and endorse the expansion of Medicaid as allowed under the Affordable Care Act. Absent that endorsement, we urge the Iowa Legislature to reject the Healthy Iowa Plan and require Medicaid expansion instead. Expanding Medicaid is the best opportunity to provide health care coverage to most Iowans. It is better for patients, providers, hospitals, academic health centers and for Iowa taxpayers.
Peter J. Reiter, MD, FACP
Internal Medicine North
chairman, public policy committee
Iowa chapter, American College of Physicians