Feds approve Iowa Medicaid expansion plan

The Centers for Medicare and Medicaid Services (CMS) on Tuesday approved a work-around proposed by Iowa’s Republican governor that will allow the state to participate in the Medicaid expansion under ObamaCare.

“Iowa has pioneered innovative, state-based solutions for Medicaid expansion, and we are pleased to grant this waiver,” said CMS Administrator Marilyn Tavenner in a statement. “CMS stands ready to work with other states to explore options that aim to improve care and lower costs in the Medicaid program.”

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Gov. Terry Branstad (R), who opposed to the Medicaid expansion, came to an agreement last year with Democrats in the state legislature on a partially privatized Medicaid expansion plan.

The Iowa plan is more stringent than the expansion implemented by 24 other states. For instance, Medicaid recipients in Iowa will face a monthly fee if they fail to participate in healthy activities.

The Des Moines Register reported on Tuesday that 16 organizations in Iowa sent a letter to federal officials urging them to quickly approve the plan. The state has been signing people up for the plan, which is scheduled to take effect on Jan. 1, but needed the feds to officially approve the work-around before then.

Families USA, a nonprofit healthcare advocacy group, applauded the Iowa announcement.

“Governor Branstad and the federal government have negotiated in good faith to find a reasonable compromise that allows Iowa to become the next state to expand Medicaid coverage under the generous financial terms provided by the Affordable Care Act,” the group said in a statement. “We trust that the Governor will move forward so that more Iowans can enjoy a holiday season with health care security and peace of mind.”

The Obama administration has said it’s open to working with state Republicans on work-arounds for aspects of the Affordable Care Act they might not be comfortable with.

The Republican governor of Tennessee on Monday said he’d also be open to expanding Medicaid under ObamaCare if the state's GOP-led legislature approves the system. Gov. Bill Haslam sent a letter to Health and Human Services (HHS) Secretary Kathleen Sebelius in which he expressed optimism that a solution could be found.


Twenty-five states and the District of Columbia have so far opted into the expanded Medicaid program, while 25 states, mostly run by Republican governors or legislatures, have said they would not move forward on the expansion at this time.