Journal Express, Knoxville, IA


March 19, 2013

IHA endorses Medicaid expansion


Knoxville —

The report says that the Institute indicates that implementation of the Medicaid expansion will increase the number of people in Iowa covered by Medicaid by 72,000 people by 2022.

The Urban Institute projects that an additional 43,000 people who are eligible under today’s eligibility rules but not currently enrolled will subsequently sign up due to the publicity and outreach related to health reform, even without a Medicaid expansion. Iowa will have to pay the regular matching rate (currently 40.4 percent) for any Medicaid-covered services obtained by these individuals.

If Iowa does not expand Medicaid to 138 percent of poverty, some residents with incomes between 100 and 138 percent of poverty may instead get health insurance through the Health Insurance Exchange. These individuals likely will be fewer in number than those who enroll in Medicaid because the exchanges will require greater contributions from recipients to enroll and to receive health care. Our analyses account for the fact that some in the 100 to 138 percent of poverty bracket will instead enroll in Health Insurance Exchanges if Medicaid is not expanded.

The report says that additional spending made necessary by Medicaid expansion will lead to more jobs. Not all of these jobs will be in the health care sector. Some will be in other areas through a broader, “multiplying effect” from increased taxpayer expenditures through Medicaid. 

The Iowa Hospital Association is backing the expansion of Medicaid, though hard figures and the actual impact an expansion will have on the state, are still unavailable. Below is a question and answer exchange between the Journal-Express and IHA Spokesman Scott McIntyre. 

• If we expand Medicaid and medical facilities no longer have “eat” as much in uncompensated care, will the charges for everyone go down? 

That’s impossible to say as each hospital would be affected differently.  Furthermore, the details of Medicaid expansion (as it would work in Iowa) are still being ironed out, so the impact is difficult to predict.  However, in the long run, it’s much more likely that overall health care costs in Iowa would be less with expansion than without it.

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