“We need to be growing Iowa’s economy, not its government,” Heartsill added. In all, Iowa will spend nearly $13 billion this fiscal year, which includes $6 billion directly from Iowans and the rest from the federal government. Per capita, Iowa’s spending will outpace that of Missouri’s, and Heartsill believes the taxation is part of the reason Iowa loses business to its neighboring states.
“Where money is best treated, that’s where it will flow,” Heartsill said.
Other issues covered Friday included Medicaid expansion and mental health reform. Bob Kroese, CEO of Pella Regional Health Center, believes entering into the agreement with the federal government to expand the low-income health coverage program would bring more money to the state. Branstad has refused to expand Medicaid, an opportunity presented under the “Affordable” Health Care Act in which the federal government promises to pay 100 percent of the increased cost for three years.
“I’ve heard from every one of your employees,” VanderLinden said. “We can’t do it. We can’t pay for it. We don’t have the money.”
VanderLinden spoke on behalf of the panel that they would each like to see everyone in the state have medical insurance, but the truth is that the money is not available for the federal government to do this. He added that no one is ever removed from Medicaid, it just continues to expand, and has become a “bottomless pit” of expenses.
Kroese said the expansion provides the opportunity to bring in more money, or to lose it to other states, which will spend it on their residents. Sheets said that for every dollar the federal government spends, 46 cents is borrowed. There is a chance the federal government will have no money in 10 years, Sheets added.
“I don’t trust the federal government on Medicaid backfill,” Sinclair said. She has investigated the possibility of expanding Medicaid and asked for real world numbers. Under the expansion, if the state loses $2 million through Medicaid, the federal government would only pay $300,000.