EXPANDING HEALTH CARE

As part of our Plan for Prosperity, I've talked about the need to
expand the availability and affordability of health insurance to
working families who cannot currently afford coverage.  Over the
past several decades, health care costs have been one of the fastest
growing segments of the state budget.  Medicaid costs have about
tripled over the past 15 years, driven by health inflationary factors
that are largely beyond the state's control.  

The good news is that the Commonwealth Fund, a private foundation that
focuses on health care issues, recently gave Iowa straight “A”s on its
report card, ranking Iowa as the only state to receive top marks in
five categories – access, quality, affordable costs, equity and healthy
lives.  The bad news is that an estimated 250,000 Iowans still
have no health insurance coverage of any kind, neither public nor
private, and 45,000 of the uninsured are children.

Children's Health Insurance Program (CHIP)
We've had some success expanding health coverage in recent years. 
Iowa adopted the state's Children's Health Insurance Program in 1998,
including an expansion of Medicaid and, for children in households with
slightly higher income, a new private insurance program called “Healthy
and Well Kids in Iowa” or HAWK-I.  There are about 35,000 children
currently enrolled in these plans.  The benefits are good and, for
HAWK-I, the monthly premiums are only ten dollars, with a maximum
monthly premium cost of twenty dollars.   

IowaCare – A New Medicaid Category In 2005, Governor Vilsack and the
Legislature succeeded in persuading federal officials to approve a new
Medicaid health insurance category – unique to Iowa – aimed primarily
at adults who do not have access to health insurance and whose adjusted
gross income is no higher than twice the federal poverty level. It's a
very limited program, covering mostly hospital procedures and related
services, and the services have to be provided at either University
Hospitals in Iowa City or Broadlawns Medical Center in Des
Moines.  The program is designed to reach people stuck in a
financial insurance gap – they earn too much money to qualify for any
sort of publicly-funded coverage, but not enough to afford to buy
private insurance on their own.  Premiums can range from zero to
$75 per month, depending upon income, and will be waived on a
month-to-month basis for enrollees claiming a financial hardship.
IowaCare enrollment is currently projected at around 22,000.

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2007 KEY HEALTH INITIATIVES

Small Business Health Insurance Pools House File 790, sponsored by Rep.
Phil Wise (D-Keokuk) and others, allows trade associations with fewer
than 50 employees to form health insurance pools.  To qualify, an
association must be at least five years old, and must let any business
that meets the association's membership qualifications join the pool
without employee health status preconditions.  Also, this
legislation lets insurers offer incentives to any small employer group
policy that encourages employee participation in wellness
programs.  Another law was enacted directing the insurance
commissioner to develop a small employer uniform application form.
 

Tobacco Tax Revenue Allocated for Health Programs

Public health professionals estimate that, by raising the cigarette tax
by one dollar per pack, youth smoking will be cut by 19 percent, there
will be 6,350 fewer smoking-affected births over five years, and
another 20,000 Iowa adult smokers will quit.  Health advocates
project that the savings due to improved health outcomes will be $867
million.  All $127 million in revenue is deposited into a separate
health care trust fund that must be used for health care.

2007 Affordable Health Care Commission
The Legislature established a commission to look for ways to increase
the number of Iowans who have access to affordable health coverage.
Commission membership includes legislators as well as representatives
of the insurance industry, health care field, and small business
owners. The House chair is Rep. Ro Foege of Mt. Vernon.

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ABOUT PAT MURPHY

Pat Murphy is the Speaker of the Iowa House of Representatives. He is
serving his ninth term representing Dubuque.  Before serving as
Speaker, Rep. Murphy spent three years as Democratic Leader and nine
years as the top-ranking Democrat on the House Appropriations
Committee.
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