Then there is the huge elephant in the room: In the unlikely event a majority of Iowa lawmakers, both in the House and in the Senate, agreed to pursue the governor’s plan, Iowa would still need to apply for and secure a waiver from the federal government to proceed. That is neither simple nor automatic.
According to many critics, including U.S. Sen. Tom Harkin, the Obama administration likely will not approve the waiver anyway.
Iowa lawmakers and Branstad have set up a terrifying scenario: The Legislature will adjourn, and it may not agree to expand Medicaid. It may not agree on the governor’s alternative plan, either. A program known as IowaCare, which provides limited health services to more than 60,000 Iowans, expires at year’s end. While our elected officials ring in the New Year with the comfort of knowing their own taxpayer-paid health insurance is safe and sound, thousands of their low-income constituents won’t have any health coverage and won’t have the money to pay for their own care.
Iowans will pay federal taxes to provide health insurance to poor people in other states. Iowans will get nothing.
So Heaton is right. The votes on legislation to get poor Iowans health insurance are the most important in a lawmaker’s career. It’s time for all of them to set aside the politics and do what makes fiscal and moral sense: Expand Medicaid to finally insure more poor Iowans.