DES MOINES, Iowa - Three years to the week since the Democrat-controlled Congress passed the Affordable Care Act of 2010, the Iowa Senate will try and move ahead on the next step to expand Medicaid throughout the state.
On Monday, starting at 5 p.m., the Senate will be open to the public to listen in as Democrats and Republicans debate the state's proper role.
Currently, about 400,000 Iowans receive services through Medicaid. Last summer, the U.S. Supreme Court upheld the ACA, leading to many governors and state legislatures to consider their responsibility and financial capability to add more residents to the Medicaid rolls. Initial estimates would make between 110,000 and 180,000 more Iowans eligible to receive Medicaid benefits.
The basic framework of the financial obligations of Medicaid expansion in Iowa includes the federal government paying all of the cost for the first three years and the state of Iowa paying up to 10% of the total cost after three years.
Republican Governor Terry Branstad has been very vocal against Medicaid expansion in the state. He has said that Iowa taxpayers could get stuck with the cost if the federal government does not pay for its stated financial obligation.
With a split legislature, leaders on both sides admit the final agreement may have to be reached at some place in the political middle.
On Sunday, we heard from two state Senators before their drive over to Des Moines for Monday's debate. Democrats hold a slim 26-24 edge in the Senate with Republicans in the majority in the Assembly.
"I know Governor Branstad is worried that the federal government will renege on the Medicaid promise," said Sen. Liz Mathis (D-Cedar Rapids). "In 50 years of Medicaid coverage, we've never seen that happen."
Sen. Tim Kapucian of Keystone, one of the few Senate Republicans in Eastern Iowa, said the federal government's debt level is a concern but also said he believes the Democrat-led Senate will make a formal push to cover between 110,000 and 180,000 more Iowans on Medicaid.
"It will pass the Senate and I think the House will pass something eventually," said Kapucian. "They won't look alike. What passes out of the Senate tomorrow will not be the ultimate end."
Leaders in the Republican-led House are expected to wait for Branstad's own proposal, called the "Healthy Iowa plan" which close insure approximately 89,000 Iowans without health insurance.
Mathis said fellow Democrats do not agree with the Healthy Iowa Plan, even saying "there is no plan."