The difference between Republicans and Democrats: Hatch also neatly summed up the manner in which a political debate is blocking progress on a pressing policy issue: “The idea [is that] participating in the expansion of Medicaid has a direct effect on our general fund. The governor and I agree on that,” Hatch said. “The difference is, he thinks it’s going to be a burden and I think it’s going to be an asset.”

In press conferences, evidence that Democrats and Republicans are worlds apart on health-care reform

By Jason Nobel - 9 July, 2012

When it comes to the health care law known as Obamacare and its implementation, Democrats and Republicans are just talking past one another.

Case in point: dueling Capitol press conferences this morning from Iowa state Sen. Jack Hatch, a leading Democrat on health-care issues, and Gov. Terry Branstad, the state’s top Republican.

Hatch, of Des Moines, called a press conference for this morning just ahead of Branstad’s regularly scheduled gaggle to offer his take on the expansion of Medicaid that is part of the Affordable Care Act, President Barack Obama’s signature health-care overhaul.

The law as written included a requirement that states increase eligibility for the program, but a Supreme Court decision last month dialed back that mandate, so that states can choose whether to accept additional federal funding to insure more people.

At his presser, Hatch, flanked by an executive from the nearby Mercy Medical Center, argued that expanding Medicaid to include more low-income Iowans would lower health care costs for everyone.

Such savings are possible because additional care provided through Medicaid would cut down on instances of uncompensated or “charity” care – services provided by hospitals to the uninsured that ultimately is paid for through higher premiums on everyone with insurance.

A nonpartisan study from the Urban Institute, he said, pegs Iowa’s health savings at as much as $1.9 billion over five years.

“Expansion of the Medicaid program would provide health-care insurance to millions of Americans who desperately need it while at the same time lowering the cost of health coverage for those of us fortunate enough to have insurance,” said Dr. Stephen Eckstat, the Mercy Clinics Inc. CEO.

But in another Capitol conference room just a few minutes later, Branstad offered a wholly different explanation for why Iowa should reject the federal government’s offer to expand coverage.

He called the expansion “clearly unaffordable and unsustainable,” arguing that insuring 17 million more Americans nationwide – including 150,000 in Iowa – would overburden an already expensive government entitlement.

The extra expense will necessitate more federal borrowing and a higher debt, Branstad said. And that higher debt will only become more expensive to finance in the years to come.

“It would be a big mistake to buy into a federal straitjacket that we know we can’t afford and they can’t afford,” Branstad said.

Hatch argued that rejecting the federal program wouldn’t take money off the federal debt, but instead merely deny Iowa the spoils offered to every other state in the nation. Branstad argued that Iowa could go its own way, partnering with insurers and providers in the state to provide more affordable care.

Hatch also neatly summed up the manner in which a political debate is blocking progress on a pressing policy issue: “The idea [is that] participating in the expansion of Medicaid has a direct effect on our general fund. The governor and I agree on that,” Hatch said. “The difference is, he thinks it’s going to be a burden and I think it’s going to be an asset.”