Democratic Legislators Present Bold Healthcare Public Option Solution

Democratic Senator Matt McCoy and Representative John Forbes held a press conference last week and presented a simple, common sense health care solution for Iowans. Their proposal “Healthy Iowans for a Pubic Option” (HIPO) solves two Iowa health care emergencies facing thousands of Iowans. Republicans’ policies and actions have created two health care disasters for Iowans and now Republicans are ignoring the desperate pleas of these Iowans. The two urgent health care emergencies are the failed Medicaid privatization and the ballooning premium increases for Iowans buying insurance on the Affordable Care Act (ACA) exchange.

The first healthcare emergency is the privatization crisis. The Branstad/Reynolds regime moved the management of Iowa’s Medicaid population from the successful state management to a reckless experiment with for-profit insurance companies. That shift has proven to be a massive mistake, resulting in delayed, denied and inadequate services for Iowa’s 600,000 Medicaid recipients.

The Branstad/Reynolds Medicaid privatization is a disaster on all counts. Branstad and Reynolds promised that turning Medicaid to for-profit companies would save the state millions of dollars. Instead, the three private companies are demanding more money and have simultaneously cut services, delayed payments and refused to be accountable for their failings. Reynolds’ Department of Human Services (DHS) has simply made excuses as providers are pushed to the brink of bankruptcy while the 600,000 Medicaid patients are suffering life threatening service cuts.

McCoy and Forbes’ HIPO proposal would return Medicaid to the previously efficient state managed control. That simple move would restore the proven state management of Medicaid from the chaos created by privatization. Prior to the Branstad/Reynolds arbitrary replacement of state management with the for-profit companies, Iowa’s Medicaid was functioning flawlessly and with few complaints.

The second health care emergency that HIPO solves is the huge spike in premiums for those 72,000 Iowans needing to buy insurance on the ACA exchange. Medica, the only insurance company offering insurance on the exchange for 2018 raised premiums by 57%. The majority of these 72,000 folks are protected by these monstrous rate increases by rising subsidies. However, the remaining 20,000 to 25,000 that don’t qualify for subsidies have seen their premiums spike to unsustainable levels. That premium increase directly resulted from President Trump and Republicans sabotaging the ACA by threatening to remove the insurance mandate and cutting the subsidies that underpin the financial integrity of the exchanges. It’s no secret Republicans have intentionally weakened and undermined the ACA resulting in massive premium increases for Iowans on the exchange.

The Democratic legislators’ HIPO legislation would specifically offer lower premiums and stabilize the market exchange. It would offer the 72,000 Iowans on the exchange an additional competitively priced public option managed through Medicaid. This legislation is focused on the 72,000 Iowans whose income is too high to qualify for subsidies. These 20,000 to 25,000 individuals have seen their premium rates double and triple thanks to the Republicans’ destructive efforts to cut federal assistance to the ACA. Many of these folks have said they simply will need to drop insurance since the Republicans’ actions have spiked their premiums beyond affordability.

The Democrats’ HIPO public option would offer these Iowans an affordable alternative to the prohibitively priced private companies like Medica. For the remainder of the 72,000 who qualify for subsidies HIPO would keep their rates low by continuing those same subsidies.

Democrats nationally are building grassroots support for a health care for all proposal. Iowa Democrats are once again leading the nation by proposing a custom Iowa public option utilizing Medicaid. This proposed legislation follows years of Democrats calling for a health care for all approach. Former Senator Jack Hatch spent years working on health care reform issues while serving in the legislature. In his book “No Surrender” Hatch called for Iowa to become a leader by proposing a public option through Medicaid.

Iowans are desperate for action to solve these two urgent health care emergencies. McCoy and Forbes have offered a realistic and practical solution to end both the privatization nightmare and the runaway cost of insurance premiums on the ACA. The next step is to begin building support for their legislation with both the public and in the legislature.

Democrats are often criticized for only offering resistance to Republicans bad ideas rather than offering solutions. The Democrats’ HIPO proposal is a powerful alternative solution that all Democrats and progressives can be proud to support.


by Rick Smith
Posted 10/30/17

2 Comments on "Democratic Legislators Present Bold Healthcare Public Option Solution"

  • What are the costs to the public sector and who pays? I suspect that the affordable premium Medicaid payments are an expansion of Medicaid requiring Federal funds covering at least 90% of the cost–a no win with Trump and the Republican congress. As a prescription of what Democrats will do if they can re-take the Iowa legislature and
    Congress it is a good start, but funding questions still need to be answered. An NPR interview with a nurse in a West Virginia County of 95,000 people indicated that they are experiencing 5 deaths/day from opiade/heroin addiction and she estimated it would take $100 million to eradicate the problem, primarily focussing on long term treatment and major intervention–in one county of 95,000 people!!!. People are dying and we are becoming swamped with an epidemic. I’ve heard that more Americans are dying from addiction overdoses than the combination of auto and gunshot deaths.. I suspect the long term solution to our health care crisis is a combination of robust mental health and drug recovery treatment programs, 100% covered prevention services (vaccinations, annual physicals, mammograms, where appropriate, etc.) and publicly-financed catastrophic care. 100% covered health care by ACA or Public Health Care is unaffordable in this political climate.

  • Of course the gutting of the ACA (which, imho, is only a stopgap to real universal coverage) is intentional. And it is then so easily spun as being the fault of that “terrible Obamacare”.
    I like that plan, and something like that should be offered on the National stage, as well. (and I do wish to dispute the last paragraph. Dems have been offering solutions and fixes since the ACA was passed, and are offered every time the Right destroys another part of it. The criticism should be that Dems have not gotten out in front of their alternatives; they are there, but get swamped by the right-wing noise generator.)

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