MASON CITY, Iowa (AP) — Gov. Terry Branstad signed a bill into law Thursday that will expand health care access for Iowa's poorest residents, though officials acknowledge they have significant work ahead to both establish the program and enroll eligible citizens.
Branstad signed the legislation in Mason City, a location selected to acknowledge two lawmakers from the region — Republican House Majority Leader Linda Upmeyer and Democratic Sen. Amanda Ragan — who helped broker the final compromise deal in May after months of contentious debate in the Legislature.
"The plan that we're signing today increases access to high-quality modern health care," Branstad said.
Under the Iowa Health and Wellness Plan, the state will accept federal dollars offered to states that expand Medicaid under President Barack Obama's health care overhaul. That funding will be used to provide health coverage for as many as 150,000 low-income residents by putting some on a new state-run program and to pay the premiums for others to get private insurance on the new health care exchanges.
The state still needs federal approval for the plan, which Branstad expects will happen. If approved, the federal government would fully fund the new coverage for three years, with Iowa then gradually picking up 10 percent of the cost.
"We even believe what we're doing could be a prototype that could be copied by other states," Branstad said.
Low-income residents who don't qualify for Medicaid in Iowa, mostly poor adults, are eligible for the plan. Some are currently on a limited benefit state plan that is set to expire at the end of the year. The plan would start providing coverage in January, with enrollment beginning this fall.
Health care advocates applauded the compromise deal, but said they still needed more information on how the plan would work and be set up.
"The bill signing is a step, but there's a lot left to be deciphered and figured out," said Matthew Covington, an organizer with the activist group Iowa Citizens for Community Improvement. "How are we reaching people to make sure they understand that this will be a benefit to them? What will be done to insure that they know how to get the best coverage and how do they use it?"
Iowa Medicaid Director Jennifer Vermeer said the state was still designing the program, which is not fully fleshed out in the legislation.
A series of public hearings will be held in late July, with plans to submit an application for federal approval around the third week of August. She said the process has been pushed back because the final agreement differed from the governor's original proposal.
Vermeer said outreach and education would include coordination with community organizations and would likely be part of the effort in August and September.
"We're confident we can get it done," Vermeer said. "It's an aggressive timeline and there's a lot to do."
Scott McIntyre, spokesman for the Iowa Hospital Association, said it wasn't unusual that details were still being worked out after a bill signing.
"A lot of times for the Legislature to get things done and make an agreement, they can't agree on the specifics. This isn't unprecedented. It's just unprecedented in terms of the subject," McIntyre said.