Sioux City hospitals push to expand Medicaid - KWWL - Eastern Iowa Breaking News, Weather, Closings

Sioux City hospitals push to replace IowaCare with expanded Medicaid


A program that provides medical services to uninsured Iowans ineligible for Medicaid is under scrutiny from local health officials. 

The goal of IowaCare is provide a limited amount of health care coverage to people who would otherwise go without.

Adults ages 19 to 64 are eligible.  Their family income must be no more than 200% of the federal poverty level.  They must be uninsured, or have a medical condition not covered by their insurance.

Services include inpatient, and outpatient hospital services, limited prescriptions, dental, and routine preventive medical exams.

Siouxland Community Health Center is the only approved provider for IowaCare patients in Northwest Iowa.  However, those  who need specialty care have just two options: Broadlawns Medical Center in Des Moines and the University of Iowa Hospitals and Clinics in Iowa City.

That burden is too much for some to bare.  The average Siouxlander on IowaCare has to travel 70-miles to see a doctor, and 270-miles to see a specialist.

The federal government is offering states a deal: expand Medicaid, and Washington will cover the costs for three years.

Roxanne Merrill's spent time in, and out, of doctors offices.

"It's a lot of driving, it's a lot of expenses," she told reporters at a press conference organized my Mercy Medical Center, St. Luke's Regional Medical Center, the June E. Nylen Cancer Center, and Siouxland Community Health Center, Friday.

The Estherville, Iowa, woman relies on IowaCare for health care coverage. So, she has to come to Sioux City to get treated.  When she needed surgery she was sent to Iowa City, and then turned around and sent to Des Moines.

"We drive a car that has 160,000 miles on it, it's the only car we have," Merrill explained.

It's stories like this that have prompted health officials to call for an end to the IowaCare program.  

"There's significant barriers for these individuals and their families," said Michelle Stephan, the CEO of the Siouxland Community Health Center.

"Folks who want to stay in this community, who want to see a specialist, who want to go to St. Lukes, who want to go to Mercy, can't, unless they go to the emergency room," stated Mercy's CEO, Bob Peebles.

Officials say patients, who are medically or financially unable to make the trip across the state, wait until the emergency room is the only option.

"That's not the best place for care, that's the highest cost and there's no coordination over time," Peebles said.

They're calling on Governor Terry Branstad to take the federal deal to expand Medicaid instead. 

"Over time, it should reduce the cost of health care," St. Luke's CEO Peter Thoreen added.

However, the Governor says Medicaid is outdated and expensive. Branstad says the hospitals are trying to get the government to bail them out of a failed deal over Medicare. When the IowaCare program for the uninsured expires at the end of the year, Branstad wants to replace it with the Healthy Iowa Plan.  The administration says it will reach 89,000 underinsured Iowans.  However, local health officials say the new plan is just an expansion of IowaCare.

"That is nothing short of a disaster for community hospitals, like Mercy," said Peebles.

Local health officials argue taxpayers dollars are going to go to expansion of Medicaid, regardless of what Governor Branstad decides.

"If we do not expand Medicaid here in Iowa, those federal dollars go to other states.  So essentially, Iowa taxpayers will be assisting in Medicaid expansion for those other states," explained Stephan.

Officials say expansion of Medicaid would reach more Iowans, and give them access to health care services right in their hometown.

"The state of Iowa is missing a golden opportunity to help more than 150,000 Iowans," said Peebles.

If Iowa accepts the deal to expand Medicaid, the federal government would pay 100% of the costs for three years.

After that, states will be required to a small part of the tab, capped at ten-percent through the year 2020.   That ten-percent would equal $270-million, according to Republican State Senator Bill Anderson.

Some lawmakers worry about how much that tab will grow after 2020.  Democratic State Representative Chris Hall says some of his Republican colleagues in the House are not sold on Governor Branstad's plan, either.

"It shows that there is some consensus on the fact that the Governor's proposal is not a serious one, that the IowaCare  program is not working, and that moving forward Medicaid expansion might be the best plant to provide equal access to health care," said Hall.

"That's gonna be costly.  I guess I'm not as optimistic about the federal government being able to continue to meet all the demands that are on them at this point, when we're borrowing such large amounts of money," Anderson pointed out.

Twenty-four states had signed up for the federal Medicaid expansion as of March 1st.


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