Health care debate continues in Des Moines

The debate rages on in Des Moines over a health care plan for Iowa.

Right now, the House and the Senate are split over the Democrats' wish to expand federal health care and Governor Terry Branstad's own plan, called Healthy Iowa.

Local Democrats are worried about the governor's plan for funding, which will pull money away from the already restricted mental health budget in Iowa counties.

"One of the key parts of the financing of his program, which costs a lot more than the Democratic program, is to take $44 million a year out of the county mental health fund, which makes no sense," said Steve Sigel, a Wapello County Democrat. "Here we are, we're already underfunded, like I talked about, we're having layoffs across the state and now he wants to take $44 million more. So that will either be a big cut from mental health or a big increase in property taxes, it's unclear yet which way he wants to go on that, but that's a serious problem and we really need to do the expansion of Medicaid because the governor's plan will cost Iowa taxpayers seven times as much."

Sigel said Wapello County is in okay shape as far as funding goes, while counties like Linn and Johnson are expecting huge layoffs, but he doesn't know how the county will handle even less funding if the governor's plan is passed.

Siegel said other red flags in the governor's plan include less people covered, less coverage for those who are covered and no entitlement.

On the other side, Republicans say Branstad's plan will cover 89,000 Iowans below the poverty level, and participants would pay a little in order to be held responsible for contributions.

The big opposition here to the federal plan lies in the belief that long-term Medicaid costs paid for by the federal government are unsustainable.

"The way I understand it is the federal plan says they'll come in and fund it 100% for the first three years, then they'll drop down to 90%," said Trudy Caviness, Chair of the Wapello County Republicans. "Once the federal government gives the rules, you've got to go by that - you can't opt out. It's once you step in, you're in. And so I think it's a good thing to take a little bit longer look at this. Now, hospitals and people with funding, they want to go with the plan they're going to get money immediately, but is that the best for Iowans?"

Caviness said another strength of Branstad's Healthy Iowa plan is that it rewards people for making healthy choices, such as attending yearly physicals or losing weight. The details haven't been laid out yet, but in essence, the plan rewards people for being healthy, on top of treating medical problems.

As for whether this issue will be resolved this session, Caviness said it's a toss up as of now. If the legislature keeps their May deadline, it could take a special session or two to come to a resolution.