Washington Evening Journal
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Neighbors Growing Together | Oct 22, 2014

Legislative briefing addresses Medicaid concerns

By Xiomara Levsen | Mar 18, 2013
Richard Gilmore

At Saturday’s Legislative Briefing there were a number of topics discussed. One of the biggest topics discussed was Gov. Terry Branstad’s plan for Medicaid.
“I think one of the biggest things that confronts us is what we’re going to do,” Rep. Dave Heaton of District 89 said. “We’re going to have to do something on whether or not we’re going to expand Medicaid. The problem with the governor’s plan is that he hasn’t really told us what’s in it.”
Heaton said that the governor has given legislators a plan. It would have more people on private insurance and the people who are below poverty level would be covered with Medicaid coverage of 40 percent.
“Hospitals are really concerned about all of this,” Heaton said. “They’re concerned also about whether or not there will be comprehensive set of benefits. Charitable care is a big issue with hospitals. The Medicaid rate is also a big concern.”
Both Heaton and Sen. Rich Taylor of District 42 have visited with local hospitals about their concerns with the plan.
“I think that the problem in all of this Medicaid expansion is how the health care is going to be delivered,” Heaton said. “The governor in his plan, as well as the Senate in their plan, will address the issue of the expansion of Medicaid.  They say that the people who are eligible for their services will get those services in an integrated critical health system controlled by the major hospital networks in the state.”
Heaton said this would restructure the entire health care delivery system in Iowa.
“In order to get your care, as far as Medicaid is concerned, you’re going to have to go to one of these integrated systems,” Heaton said. “Is Washington Hospital in the integrated system or not? I don’t think they’ve elected to join the system. Neither is Mount Pleasant and neither is Fairfield.”
Heaton said the smaller hospitals are skeptical about not being independent in the health care system.
“I don’t like what I see,” he said. “I don’t like the direction that we’re going. I worry about our critical access hospitals and so, to me, this issue of Medicaid expansion and how health care services will be delivered is probably one of the biggest decisions that I’m going to be involved in.”
Taylor agreed with most of Heaton’s comments about the health care bill.
“The governor just came out at least with a partial plan that’s going to cost us $163 million dollars,” Taylor said. “His plan is not complete, so we owe him the courtesy to look at his plan, but we need him to get it complete.”
This is one of the major items keeping the legislative branches from getting anything done, Taylor said.
“The smaller community hospitals have a legitimate concern on how this is going to be delivered,” Taylor said. “And how they’re going to get paid. It looks like right now the big guys on top are going to do fine and our community hospitals aren’t going to do so well. I think we need to work something in to the plan, either plan, to deal with that. I think we need to do that rather than just jump on board. We should try to fix it in the first place.”
Mark Knupp, a farmer north of Washington, said he is concerned about the cost of health care.
“Hard cold facts—I’m self-insured,” Knupp said. “My insurance has gone up 44 percent in the last three years. I talked to a farmer friend that happened to turn 60. This year he goes into the next higher pool. He just got a 55 percent increase on his health insurance the next year. Help us figure this out.”
Heaton said the way he understood it is the health care pools of the age group drives that cost.
“The amount of money that the seniors will pay is capped,” Heaton said. “Today the younger people are paying less but the seniors probably won’t pay more, but it will probably shift to the younger people to pick up some of the costs.”
Richard Gilmore attended the session on behalf of his wife, Dr. Robin Plattenberger, of the Washington County Hospital Medical Clinic. He said his wife is concerned about the future of Washington County Hospital.
“The hospital, it needs Medicaid flat out,” Gilmore said. “That’s where we’re at.”
Taylor said that is what he has heard from all the community hospitals. He said it may not be the best option for the hospitals but it is still an option.

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