December 10, 2013



Des Moines, Iowa

A Democratic gubernatorial candidate blamed Republican Gov. Terry Branstad Monday for the delay in expanding health care to Iowa's low-income residents, alleging the governor's insistence that the poor pay a small premium for coverage has made the federal government reluctant to approve the plan.

State Sen. Jack Hatch, of Des Moines, said Branstad's push for monthly premiums for people enrolled in the new Iowa Health and Wellness Plan has been a sticking point with officials from the Centers for Medicare and Medicaid Service. Hatch said he spoke recently with the federal officials about the approval process, and they expressed concerns about such fees for the very poor.

"The logjam with CMS can be broken if the governor will move away from his insistence on premiums," Hatch said in a statement.

Branstad has previously acknowledged that premiums were a point of debate. But he noted Monday that the Legislature approved the plan with bipartisan support and said that the use of premiums will improve health outcomes.

"The whole idea here is to encourage people to do the right thing," said Branstad, who has not announced his plans but is expected to run for re-election next year. "I don't think legislators have any place in interfering with the negotiations that are going on."

The Iowa Health and Wellness Plan is a new health-insurance program that would cover up to 150,000 residents who aren't on the current Medicaid plan. If approved, it would start providing coverage Jan. 1.

Under the Iowa plan, which was approved by lawmakers in May and submitted to federal officials in August, those with incomes up to 100 percent of the poverty line - under about $24,000 annually for a family of four - would go on a new state-run health plan with benefits similar to those offered to state workers. People with incomes from 101 to 138 percent of the poverty line - between about $24,000 and $32,000 annually for a family of four - would get private health plans on the new health-care exchanges; those premiums would be paid for with the federal dollars.

Starting in 2015, participants with incomes that are more than half of the federal poverty level could be subject to small monthly contributions, if they don't meet certain health goals. The out-of-pocket costs could not exceed 5 percent of their annual income.

More than 50,000 Iowa residents are already signed up for the Iowa Health and Wellness plan, all of whom are currently on a different low-income health program set to expire at the end of the year.