DES MOINES - Federal authorities have not signed off on Iowa's low-income health care expansion because they do not like the use of premiums in the plan, Gov. Terry Branstad said Thursday.
Branstad met with federal officials in Washington this week to urge them to provide a waiver enabling the state to receive more federal Medicaid money for the proposed Iowa Health and Wellness Plan, a new health insurance program that would cover as many as 150,000 residents.
Branstad said the program calls for eventually charging some small premiums that are intended to serve as health incentives. He said participants can avoid the charges if they complete certain health goals.
"We've got pretty much everything else resolved except this one last point, and that's what we told them. We'd like to see this done," Branstad said.
But the clock is ticking, and millions of dollars in new Medicaid funding hangs in the balance.
The governor said he would like to have the waiver in place by Oct. 1. That's when enrollment opens for the new health care exchanges, the online marketplaces created under President Barack Obama's health care law that allow users to buy and compare health insurance.
If approved, the new program would start coverage January 1. Some of the eligible people are currently on a limited-benefit state health plan that is set to expire by the end of the year. Without a new program in place, they could lose coverage.
Branstad said he had no indication of a timeline from federal officials. A public comment period for people to weigh on the proposal with the federal government concluded Thursday.
A spokesman for the U.S. Department of Health and Human Services did not immediately return a call for comment.
Iowa lawmakers in May approved legislation that accepts federal dollars offered to states that expand Medicaid under President Barack Obama's health care overhaul. The plan would cover up to 150,000 low-income Iowans, but not on the current Medicaid plan.
Under the Iowa plan, which was submitted to the federal government last month, those with incomes up to 100 percent of the poverty line - under about $24,000 annually for a family of four - would go on a new state-run health plan with benefits similar to those offered to state workers. People with incomes from 101 to 138 percent of poverty - between about $24,000 and $32,000 annually for a family of four- would get private health plans on the new health care exchanges; those premiums would be paid for with the federal dollars.
Starting in 2015, some participants could be subject to small monthly premiums, but those could be waived if they complete certain health goals or in cases of hardship.