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Healthy Iowa Plan

As we might have heard there is an ongoing debate about expanding Medicaid or renewing andexpanding the Iowa Cares program which has now been renamed the Healthy Iowa Plan. Theproposal expanding Medicaid in Iowa would add an additional 153,000 Iowans to the Medicaidrolls with the federal government paying 100 percent the first three years, then promising to pay90 percent the following years. My largest concern is there is no guarantee that our governmentwill follow through with their promise to pay. Assuming we someday send elected officials whodecide to spend less than they take in, it is my belief this Medicaid expansion would fall on thetaxpayers of Iowa.

The Healthy Iowa Plan will utilize Accountable Care Organizations (ACOs) being established inMedicaid and the private sector. Plan participants will have a medical home that will work tocoordinate their care. That coordination leads to healthier outcomes than the patchworkMedicaid system. It provides a commercial-like benefits package that includes in and outpatientservices, physician services, prescription drugs, home health, durable medical equipment,therapies and some transportation. The new plan rewards health care providers for helping makeIowans healthier. The Healthy Iowa Plan uses a value-based reimbursement model to incentivizeACOs and the health care delivery system. This means providers no longer have a fee-for-servicemodel; rather they focus on quality outcomes for Iowans. This payment methodology is modeledafter those seen in the private sector.

The Healthy Iowa Plan would cover all of the approximately 89,000 uninsured Iowans earningbelow 100% of the Federal Poverty Level (FPL). Individuals above 100% FPL are eligible fortax credits to purchase affordable private health insurance through the Health InsuranceExchange. The tax credits alone will reduce Iowa’s uninsured population by more than half.Purchasing private insurance on the exchange gives people the opportunity to choose what is bestfor them and their family.

The Healthy Iowa Plan, unlike Medicaid, is designed to implement personal responsibilitymechanisms to encourage members to be cost conscious consumers of health care. The HealthyIowa Plan:

  • Provides individual accounts designed to help pay for copays and deductible expenses.
  • Requires individuals to make monthly contributions to their account and provides State matching contributions to help pay for out of pocket expenses.
  • Allows individuals to earn bonus contributions to their account for completing risk assessments and preventative services.
  • Potentially eliminates required contributions for the very low income (below 50% of FPL) through participation in the Healthy Behaviors Program.


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