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Neighbors Growing Together | Apr 23, 2018

Health care reform needed, flexibility desired, Reynolds says

By Erin Murphy, Lee Des Moines Bureau | Jun 27, 2017

DES MOINES — Iowa Gov. Kim Reynolds says she is monitoring Congress as lawmakers draft legislation that would make sweeping changes to federal health care policy.

Reynolds said Monday she believes federal action is needed because health care reforms made under former President Barack Obama, a Democrat, are “collapsing,” and she is hopeful the current, Republican-led effort will produce federal policy that gives states the flexibility to use federal funding to craft their own health care programs.

The state recently petitioned federal regulators for permission to divert $352 million in anticipated federal funding for 2018 to a restructured system of premium tax credits and a state-run high-risk pool.

At the time, Iowa was facing the possibility of becoming the first state in the country without at least one health insurance company selling federally-approved plans statewide. Minnesota-based Medica has since said it will continue to sell plans statewide next year, but with an average monthly premium increase of 43.5 percent.

“Probably one of the biggest things that (Congress) could do, and that’s in our stopgap proposal, is to give us some flexibility in how we design the program,” Reynolds said Monday during her weekly news conference. “Because we know what Iowans need. I don’t know what Colorado needs. I don’t know what North Dakota needs. But I know the health insurance environment in Iowa.”

The Republican proposals — the House passed its version and the Senate is working on a similar bill — would undo many of the reforms passed by Democrats in 2010.

The GOP proposals would remove the requirement that all individuals purchase health insurance, alter the federal subsidies designed to help low-income residents purchase insurance, soften the requirement that all patients be eligible for coverage regardless of preexisting conditions, and reduce federal funding for Medicaid, among other provisions.

The nonpartisan Congressional Budget Office projected that if the House or Senate bill were to be implemented, more than 20 million people would become uninsured over the next 10 years, either due to lack of access or by choice.

The proposals have been unpopular with health care advocacy groups and the public.

Only 3 out of 10 people said they find the Republicans’ health care plan favorable, while more than half said they find it unfavorable, according to national polling by the Kaiser Family Foundation, a nonprofit, nonpartisan health care policy think tank.

Health care industry and advocacy groups like the American Medical Association and AARP are among the dozens that oppose the legislation.

Reynolds, a Republican, said because of the issues with the individual marketplace in Iowa, she is happy to see Congressional Republicans working on health care reform.

“Our carriers are leaving because it’s not sustainable. So we need to stabilize the individual market. And this is part of the process to move that forward. So I’m happy that we’re moving the process forward,” Reynolds said.

“They’re addressing this through reconciliation and then hopefully, if we can get something passed in the United States Senate, they’ll go to conference committee and we’ll start to address the Obamacare (Democrats’ 2010 reform) that is unworkable, unsustainable and unaffordable.”

If thousands of Iowans lose access to health care through GOP reforms, Reynolds said there are other ways to help vulnerable residents.

“There’s a lot of different ways that we can work with vulnerable Iowans. It starts with helping them get the skills that they need to fill the jobs that are available today. There’s a means of providing a safety net as they get the skills that they need,” she said. “I think the more that we holistically can look at how we meet the needs for those individuals, but most importantly help them succeed and help them have a great quality of life, but making sure that there’s some type of a safety net there along the way— so we’re not ripping that out from underneath them, but phasing it out while providing them options to get a great job and have a great quality of life. I guess that’s what I’m looking for.”

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