As Iowa Goes: Another Republican governor expands Medicaid

As Gov. LePage (R-ME) announces that he’d veto a bill that pays the hospital debt via his plan and expands Medicaid (and then release the voter-approved bonds he’s held up so far), another Republican governor has taken a very different path.

Iowa, the Hawkeye State, is like Maine in that it has a Republican Governor and a Democratic state legislature.

But, as an Iowa news outlet reported:

Iowa will accept federal funding to expand health care to low-income residents under a compromise reached between statehouse Democrats and Republican Gov. Terry Branstad, Senate President Pam Jochum says.

The legislation will be called the Iowa Health and Wellness Plan. Jochum said the state will accept federal funding from Medicaid expansion to cover approximately 150,000 new enrollees.

What a contrast. In Iowa, the parties worked together to get more of their low income, working citizens health care.

In Iowa, 150,000 people will gain Medicaid coverage. In Maine, 70,000 would, if only Republicans would agree.

Yet in Maine, Gov. LePage and many legislative Republicans have shown no interest in forging a compromise.

I listened to the Maine Senate debate the other day and didn’t hear Republican senators voice concern for the uninsured.

We know that people without insurance often put off or don’t seek medical care when they need it. Sometimes they die prematurely because of that, leaving behind children, spouses, friends, parents, siblings, and others who care about them.

But Republicans at the legislature and elsewhere called discussions of the hardships faced by uninsured individuals appeals to emotion, rather than a policy problem that could be solved.

Even more, Gov. LePage and his allies regularly call Medicaid expansion “welfare.” This is both demeaning and confusing language. “Welfare” has negative connotations.

And the confusion the term spawns is evident in comments on-line, in which Medicaid expansion opponents say that they don’t think people “on the dole” shouldn’t get health coverage. Yet those who would be covered are working people – but their employers don’t cover them and they can’t afford health insurance.

Republican legislators now say they want to study Medicaid expansion, but they never spearheaded such an analysis before now. Instead, the governor veered between negatively characterizing Medicaid and claiming he would get the federal government to grant him provisions that directly conflict with the Affordable Care Act. Truth is, there has always been zero chance of Maine getting that very, very special deal.

Not only has Medicaid expansion been spoken about in derogatory ways, Maine Republicans haven’t pursued health policies that would both lower costs and reduce illness and deaths.

Medicaid expansion aside, these include intensive care for people with chronic illnesses and efforts to encourage participation in the health insurance marketplace which will open enrollment on October 1.

Yet halfway across the country and in other states where Republicans exert political power, Medicaid expansion and other policies have been adopted that preserve health, prevent deaths, and help people avoid huge bills and bankruptcy.

We used to say, “As Maine goes, so goes the nation.” Today Maine lags, as Iowa and other states lead.

Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.