Cownie Statehouse Report: Legislative Approval Not Needed for Governor's Healthy Iowa Plan

By Rep. Peter Cownie

Health-care is an issue that elicits passion from nearly every Iowan, and certainly strong opinions from elected officials.

Most proposed solutions are extremely expensive and fail to deliver quality care in an efficient manner for those who depend on it. The latest example of health-care reform is President Obama’s Affordable Care Act, a signature piece of legislation from his first term in office that is starting to affect Iowans, whether you agree with it or not.

Part of the Affordable Care Act mandates that an exchange be established as an option for states so its residents might access a government-backed healthcare plan of some variety. The exchange is designed to provide health-care for state residents who are not currently covered or who desire different coverage from what an employer offers. How it works is:

• A state may completely opt out of creating an exchange, which leads to the creation of a federally mandated version;
• A state may create a state-based exchange; or
• A state may enter into a federal-statepartnership to establish an exchange.

Twenty-six states have defaulted and let the federal government create an exchange for them. Seventeen states have chosen to create their own version. While seven states have chosen to enter into the state-federal partnership model, which Gov. Terry Branstad chose for Iowa last month, and has received conditional approval from Health and Human Services Secretary Kathleen Sebelius.

"When it comes to state-federal partnerships dictated by Washington, DC,  one can never be too prepared."

In the plan chosen by the governor, Iowa will retain control of insurance regulation in the state, plan management functions of the exchange, and determine Medicaid eligibility. The federal government will be responsible for creating, implementing, and operating the actual exchange itself that individuals may use to purchase insurance.

At this point there will not be any legislative approval necessary to create the exchange. Gov. Branstad and the Executive Branch will be responsible for the state-federal partnership exchange.

Should this change, I would expect any legislative action to go through the House Commerce Committee, which I chair.

However, during my time serving Iowans at the Statehouse I have learned anything can change at any given moment, and I wouldn’t be surprised if the Legislature did ultimately become involved in the health-care exchange this session.

If that time comes, we will be prepared. When it comes to State-Federal partnerships dictated by Washington, DC one can never be too prepared.

(Rep. Peter Cownie, R-West Des Moines, represents District 42, which includes West Des Moines and part of Warren County. Contact him at Peter.Cownie@legis.state.ia.us or 515-281-3221.)