Mercy Medical Center Sioux City
Siouxland Agencies Written Testimony Medicaid Expansion
Start Date
Mercy Medical Center, St. Luke’s Health System, Siouxland Community Health Center, Siouxland Mental Health Center and June E. Nylen Cancer Center wish to express their stance today in supporting Medicaid expansion for meeting the demands of a growing uninsured and underinsured population.

Medicaid is currently available for some very low-income families with dependent children and pregnant women. It is difficult for lower-income adults without dependent children to qualify for Medicaid. The federal government has set aside enough money for states to provide health care coverage for uninsured Iowans who earn below 138% of the Federal Poverty Level. This session the Legislature and Governor Branstad must decide whether or not to accept these funds.

The federal government will cover 100 percent of the costs for the first three years. Eventually the permanent federal share becomes 90 percent for the expansion population. As a practical matter, if the state chooses not to accept the funds, our federal tax dollars will be used for Medicaid in other states.

By accepting the federal funds we would improve the overall health and well-being of 150,000 Iowans and contribute to Governor Branstad’s goal of making Iowa the “Healthiest State in the Nation.” A 2010 issue brief by Mathematica Policy Research, Inc. which compiled available studies and literature on the uninsured and outcomes, revealed a strong relationship between insurance coverage and health outcomes. The brief noted that uninsured adults are less likely than insured adults to receive preventive services or screenings, such as mammograms, pap smears, or prostate screenings. It further noted that even when uninsured individuals are aware they have a chronic condition, they are less likely than insured adults to have a usual source of care or regular checkups resulting in more emergency department visits and greater short-term reductions in health.
Medicaid expansion will help keep overall health care costs down and help Iowa businesses be more productive by keeping the workforce healthy. The reality is that when some people receive “free” care, those costs don’t disappear—other payers in the health care marketplace absorb them. Because most people receive health insurance coverage through their employer, Iowa businesses are indirectly bearing some of the cost of uncompensated care through higher insurance premiums. Failure to accept federal funds to cover more hard-working Iowans makes the state less competitive with other states that choose to take advantage of this opportunity. Keeping people healthy and on the job by adequately addressing health care needs before they become so severe that productivity time is lost is a hidden component of health care costs.
Iowa needs to align with the other states and cooperate with the federal government on the expansion of Medicaid. The care of patients and the future of jobs in the health care industry are at stake. Medicaid expansion should be accompanied by reform and redesign of today’s healthcare delivery system and payment system. We must work together to address the challenges of assuring we have a professional workforce appropriately prepared.

Together our call to action is to make the system better for health care consumers, especially those most underserved. We embrace change, whether it is through Medicaid expansion or other solutions, real solutions, to increasing access to care, eliminating barriers, and working together to build a healthier community.