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Medicaid's Future in IowaBy Chris Earl, Reporter
IOWA CITY, Iowa - In the hours after the Supreme Court’s ruling on Thursday upholding much of the framework for the 2010 Patient Protection and Affordable Care Act, now states are scrambling to decide how to operate their Medicaid systems.
Medicaid was formed in 1965, primarily for adults with dependent children and those with certain disabilities. The 2010 legislation opens the eligibility to include persons of working-age (18 to 64) who do not need to have dependent children at home but must remain under a certain income. “(This legislation) removes all of those categories and bases it on income,” said Keith Mueller, University of Iowa professor in the College of Public Health. “There is no asset test. It is what is reported on the IRS form.” Mueller has followed the ACA closely as well as the weeks leading up to Thursday’s Supreme Court decision. Governor Terry Branstad called the decision “disastrous” and said, in a televised interview on Thursday that the state might not have the financial backing to covering up to 150,000 newly-eligible Iowans under the expanded Medicare. “It will be up to the states between now and January 2014,” said Mueller, who noted the federal government will pay for all of the funding at the start before phasing out up to 10% for the states after a few years. Mueller said, years ago, some people in low-income situations would move to other states, such as New York or California, where the Medicaid benefits were greater. He said, if the 50 states are now deciding on their own how to proceed and what to offer, a similar reaction could take place. “There could be some of that,” said Mueller. “Some movement based on which states do and it’s possible if you’re in one of these categories and having a hard time finding a job and in a state that did not change it’s Medicaid eligibility, you may think of moving to a state that has.” The Iowa City Free Medical Clinic could also see an effect from more people on Medicare. Executive Director Barbara Vinograde, who has worked here for 20 years, said the clinic serves more than 2,500 people a year. “The patients who come to this clinic do not have any kind of insurance,” said Vinograde. “People we see here are people from 18 (years of age) to 64. I think it is certainly not the answer but it is part of the answer.” |
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