From Monte Neitzel, CEO, Greater Regional Medical Center; and Kirk Norris, Iowa Hospital Association president/CEO
The Iowa Hospital Association supports Medicaid expansion for the simple reason that insuring more Iowans is good for everyone, whether you provide health care, have your own insurance, own a business or just want Iowa to be a better and more prosperous place. People who are insured are more engaged with the health-care system. People with insurance have a primary care physician, get routine care, keep up on their immunizations and medicines.
People who are uninsured find it difficult to do any of these things. They ignore health problems and delay care until they end up in an emergency room – the most expensive place there is to get health care. The problem, and the cost, is multiplied when an uninsured patient is dealing with a chronic health condition like diabetes, which is often the case. Their care is costly and anyone who is insured helps pay for it.
This is also an economic issue. Medicaid expansion will bring as much as $600 million to the Iowa economy. That is an economic infusion on par with landing a major corporation. Expansion money will flow from border to border, find its way to Main Street and create tax revenue for the state.
For those who say Iowa cannot afford to expand Medicaid – the fact is we cannot afford not to. First of all, 100 percent of the funding for the first three years comes from the federal government. After that, Iowa's share will slowly ratchet up but never higher than 10 percent.
This is funding that already exists through the taxing provisions of the health-care reform law and cuts to Medicare provider payments, including $2 billion in cuts to Iowa hospitals. Our hospitals agreed to those cuts with the expectation that under health-care reform more people would become insured, leading to a decrease in uncompensated care, which now costs Iowa hospitals about $1 billion a year and is increasing 10 percent a year.
Ignoring this opportunity means millions of Iowa dollars will go elsewhere, that other states will benefit from Iowa's sacrifices – while Iowans will get nothing. It also ignores the reality that these thousands of low-income Iowans are getting health care, but it is being provided in a very sporadic, inefficient and expensive manner that we all pay for – because they are uninsured and living on the fringes of the health-care system.
We can change that through Medicaid expansion. We can help our neighbors, help our state and help ourselves. It is an opportunity we must not pass up.