The U.S. Department of Health and Human Services finally approved most of Iowa's proposed Medicaid expansion plan (AKA: our Affordable Care Act plan of action) -- with only three weeks to spare! The only part that seems to have been disallowed has been Governor Terry Branstad's desire to charge a 3% insurance premium for Iowans who earn more than 50% of the federal level of poverty. In other words, anyone making more than $5,745 per year or $478.75 per month (for a household of one)! Those fees would have been waived if individuals completed certain "healthy behaviors" such as getting their physical once annually or reducing their BMI by a certain percentage during a given year or by participating in a smoking cessation program (not necessarily being successful at that last one!).
The HHS' approval extended Medicaid to eligible Iowans who make up to 138% of the federal level of poverty (or about $11,500/year or $958/month). Iowans who earn up to 138-150% of the federal level of poverty (or up to $17,235/year or $1,436.25/month) will qualify for insurance purchased through the Affordable Care Act's marketplace and their premiums will be paid for through the government.
Governor Branstad is still processing this development, according to Radio Iowa. He wants people to "take ownership of their own health." He doesn't believe that most people will get a physical or attend to other healthcare goals unless they suffer "the threat of a premium." (On the other hand, I don't see him seeking to waive premium expenses for state employees on their own health care plans if they meet those very same healthcare goals. But I digress...) Governor Branstad has 30 days to appeal the HHS's decision. It's unclear at this point what he will do.