DES MOINES - As lawmakers struggle to complete their work and adjourn the legislative session, some wonder whether the best way to deal with a contentious health debate is to skip the matter for now and hold a special session later.
It's been seven years since the Legislature held a special session, but they have been used sporadically over the years to address complex issues. The last time was in 2006, when the legislature returned in July to override a veto from then-Gov. Tom Vilsack of a bill that put new restrictions on the ability of local governments to seize private property. Other special sessions have dealt with tax votes and budget cuts.
In the past 50 years, lawmakers have joined for 15 special sessions. There were five years when two special sessions were called.
This time, some lawmakers think a discussion over whether to expand Medicaid may be too complicated to finish in the coming days in addition to work on taxes and education policy. Delaying the health care issue would allow for further debate among legislative leaders and the governor, with the full legislature called back when a compromise had been struck.
Lawmakers also received their final daily expense payments on May 3, so many are also eager to conclude the session.
House Speaker Kraig Paulsen, R-Hiawatha, said this week that he doesn't want to rush this process.
"It is more important to get it right than it is to get it fast. We want to be sure when we pass something it works for all of Iowa," Paulsen said.
But Sen. Jack Hatch, D-Des Moines, who is working to pass a Medicaid expansion, said its essential lawmakers resolve the matter. He argues the budget cannot be completed without a decision on Medicaid.
"How can you have a special session when you have the two sides so far apart," Hatch said. "What concerns me is that we will adjourn without addressing one of the most important issues of my career, which is providing health care to low income Iowans."
The debate is over whether to expand Medicaid as permitted under President Barack Obama's health care overhaul or to approve an alternate proposal offered by Gov. Terry Branstad. Democrats, who control the Senate, have advocated on behalf of Medicaid expansion, while Republicans running the House prefer Branstad's plan to revamp an existing program for low income Iowans.
Democrats say their plan would provide better coverage to more people. But Branstad says the cost of an expansion is unsustainable and argues his plan would ensure better health results.
The Medicaid program in Iowa provides health care for more than 400,000 financially needy children, their parents, disabled people and the elderly using state and federal dollars.
The Senate has passed a bill that would expand the Medicaid program in Iowa. An expansion to include those with incomes up to 138 percent of the poverty level would add an estimated 150,000 to the state's Medicaid rolls. Under Obama's health care overhaul, the federal government would pay the full cost for the new enrollees during the first three years of the expansion and then 10 percent of the cost would gradually be shifted to the state.
Branstad's plan is called Health Iowa and would be paid for with state and federal funds. Healthy Iowa would provide coverage to an estimated 95,000 residents with incomes up to the poverty line. The state cost for Healthy Iowa is estimated at $162 million per year, with the funding coming from the state general fund, local property taxes and other sources. The state would need to get a federal waiver to put the plan in place. Participants would be responsible for contributions, though they could seek to reduce those through participating in health incentives or avoid the contributions due to hardships.
So far the two sides have found little to agree on. Hatch said there was some progress on the issue Friday, as staffers for legislators and the governor met to discuss the proposals.
Tim Albrecht, a spokesman for Gov. Terry Branstad, said the governor would consider a special session. Under state rules, the governor can call for such a session or the legislature can establish one with the support of two-thirds of the members in each chamber.
"The governor remains committed to finding a solution to this important health care issue and is willing to explore the idea of a special session if that will help bring it to a successful conclusion," Albrecht said.