In spite of a federal announcement Tuesday to the contrary, Governor Terry Branstad says they're still talking with the feds to get Iowa's application approved for an experimental program to replace the state's Medicaid program.
Tuesday, the Centers for Medicare and Medicaid Services released a statement to the media, saying they had approved 'virtually all" of Iowa's application. However, the approval negated part of the plan that was approved by the Iowa legislature this year.
The "Iowa Health and Wellness Plan" would allow the state of Iowa to use federal Medicaid expansion dollars to buy health insurance on the Obamacare exchange for Medicaid-eligible individuals. The plan also would require recipients whose incomes were 50 percent above the federal poverty guideline to pay a small portion of the monthly premiums. The CMS announcement Tuesday would only allow those premiums to be charged to Iowans with incomes above 100 percent of the federal poverty guidlines.
On the "Call Governor Branstad" program on WHO Radio Tuesday night, the governor said that the CMS was "premature" in their announcement, saying they are still in "a dialogue" with federal officials. The governor says he can't approve of the CMS plan to only allow half of the waiver request.
But he told WHO Radio listeners Tuesday night that he's "still optimistic" that federal officials will approve the full Iowa waiver request.
If they don't, Branstad would likely have to call the legislature into session early, or wait until they convene in mid-January, to decide on changes to the program.
The governor, however, has been adamant in ensuring recipients have "some skin in the game" in the form of premiums.
However, the plan also has wellness and health incentives that can negate or reduce those premiums, so his administration says the proposal is not an unfair burden.
Democrats-particularly those in control of the Iowa Senate-pressed hard last year to simply approve the expansion of Medicaid to those who make up to 150 percent of the federal poverty level. They agreed to the Branstad plan as part of negotiations that signaled the end of the 2013 legislative session.
Senate President Pam Jochum, who floor managed the bill, sent out a press release praising the CMS approval and urging the governor to approve it, saying, "The result will be healthier Iowans, fewer home foreclosures and family bankruptcies due to medical bills, and lower health care costs for all Iowans."