Hospitals across the nation supported passage of the federal Affordable Care Act (ACA) in 2010 as a means of providing health insurance to millions of Americans with little or no ability to afford coverage. In June 2012, the U.S. Supreme Court upheld almost all of the provisions of the ACA, including the legality of mandating all citizens to purchase health insurance coverage.
In its ruling, the Supreme Court rejected only one provision of the law: the federal government’s ability to withhold existing Medicaid support to states that do not expand Medicaid coverage to adults ages 19-64 who are at or below 133 percent of the federal poverty level. In Iowa, this population is estimated to be around 150,000 people.
Under ACA, Medicaid expansion is by far the primary means for providing coverage to uninsured citizens. Rather than creating a national mandate, the Supreme Court ruling now leaves individual states with the opportunity to expand Medicaid, much like the program’s original adoption in 1965. This means that the Iowa General Assembly will face a decision regarding Medicaid expansion when it reconvenes in January 2013.
At its August meeting, the IHA Board considered a broad set of implications regarding this topic and concluded that expanding Medicaid is the appropriate public health policy for Iowa. IHA’s position is that Medicaid expansion is not only good for the state and its 118 community hospitals, but also for individual Iowans and Iowa businesses. Details of IHA’s perspective are laid out in a policy brief endorsed by the IHA Board.