Beware of any gov't program that offers anything for free. We apparently have not learned that yet. We will all be exposed to a huge tax increase next Jan when Obamacare kicks in. 23 NEW taxes.

Gov Branstad is using a strawman argument: "I'm afraid that . . ." to position himself ideologically against Medicaid. We all know that regressives oppose Social Security, Medicare and Medicaid, and want to weaken government. There is nothing new in his opposition to federal assistance.

I dare Governor Brandstad and his family to live on IowaCare for a year, making a little over minimum wage. Only then could he make an informed decision.

Oh, by all means. Let's let the federal government, which is currently broke and borrowing/printing money daily to stay afloat, provide more money and promises to the states. I applaud the Governor's caution on this matter.

...and yet Iowan's tax money still pays for it...we just don't get anything out of it. That is the bottom line.

It's a bait and switch. Branstad is right (this time) to oppose it, since it is part of the ploy to get to a single-payer system (federal), and Iowa can do better on it's own.

We will pay for health services to the uninsured one way or another. We can expand Medicaid and help over 100,000 Iowans with health coverage OR we can wait until they are so ill they have to go to the emergency room OR we can watch as Iowans choose between staying healthy or going bankrupt from medical bills. I fear Iowans are losing their compassion.

Iowans will get a lot out of expanded Medicaid. A healthier, more productive population. Branstad is so ideological and mean-spirited, he would rather force the sick and poor into a marginal care system--IowaCare--that expand Medicaid. The Republicans are all only about fear. He has no compassion for his fellow human being and fellow Iowans. Shame on him.

I agree with Jason M. and I believe expansion of Medicaid is the right thing to do for our fellow Iowans. Our government is in debt because of Bush's wars and lower middle class incomes. The wealthy have all the money and pay a lower tax rate. How does that make sense? If the country is bankrupt it is entirely the fault of the Republicans,
Jason M. -- "and yet Iowan's tax money still pays for it...we just don't get anything out of it. That is the bottom line."

The governor seems to think that if we don't take care of the needy and elderly they'll move to another state that will take care of them. It is like he thinks ignoring our growing elderly population will result in Iowa's gentrification. He forgets that the very people that he as our supposed leader is duty bound to take care of are the very ones who can't afford to leave Iowa. His thinking is elitist - un-Iowan.

We have a budget surplus. We do not need the Feds.
We can take care of our own. And should.

I still find it hard to believe that certain people don't understand fiscal responsibility. The people who don't have anything want everything for nothing and those of us that have worked hard, are tired of paying for the aforementioned. Instead of enabling those who made bad decisions or like to "milk" the system by expanding Medicaid, let's offer encouragement to people to better themselves by learning a trade or enrolling in programs ALREADY available.

With our surplus (800 million), we need to give it back to those who paid more than what we really needed. Democrats want to spend more than we'll bring in! Read Jack Whitver's column. Simple accounting.

An excerpt from an editorial piece by Star Parker that sums this up.

"A classic explanation for why free markets produce prosperity and socialism does not is that individuals benefit in government-run markets by taking from someone else. In free markets, individuals benefit as a result of serving others, making everyone better off.

Medicaid violates basic management principles. There is no clear institutional responsibility. It has grown through funding from both state and the federal government. Anyone who has ever run an organization knows that absence of clear responsibility produces bad results.

Medicaid spending has grown from 0.5 percent of GDP in 1970 to 2.7 percent of GDP in 2010, and according to Medicaid's chief actuary, "From program inception, the cost of Medicaid has generally increased at a significantly faster pace than the U.S. economy."

And there is no individual responsibility. Medicaid is a pure welfare program. Participants have 100 percent of their costs covered by the government. Once you have qualified, there is no time limit. There are no incentives to behave and spend efficiently. The only direction of Medicaid is to spend more and more money less and less well."

Jim, don't confuse medicaid with other programs. Look up the eligibility requirements. It is blatantly unfair to blame medicare recipients of making "bad choices" or trying to "milk" the system. Folks who have worked all their lives can find themselves in a medical situation that costs more than they can afford. It is humane to help them.

Whoops, I typed " medicare" in the second line when I meant to type "medicaid."

For those of you who think this is "bait and switch" or some other scam from the federal government -- just know that more than half of Iowa's budget comes from federal money. Are you prepared to return all of it, like you are with Medicaid expansion? Admit it -- you know expansion is a smart deal and the right thing to do, you are just putting political ideology ahead of Iowans. Are you really willing to let others get sick and die just to score political points against the president?

IowaCare has been Iowa's stopgap system for low income Iowans for the past 10 years. Discontinuing IowaCare without meeting the legal requirements for Medicaid expansion will result in large increases in uncompensated care in Iowa hospitals. If you want more than 2 hospitals in Iowa, I would suggest that you encourage your lawmakers to work hard to meet the federal guidelines. The Federal government now pays 59% of IowaCare. Do we want it to be zero?

The governor's plan excludes mental health...as a mental health profressional we struggle daily with finding appropriate services and getting our clients the help they need. More and more of our patient's are going to jail instead of getting the help they need.

Rural counties are going to pay for the brunt of the Governor's plan, both in financial and human cost. By Governor Branstad leaving out mental health coverage, county governments are left holding an increased cost. This means raising property tax. Living in Dallas County for only 2 years, I am more familiar with Franklin and Hardin County budgets. Both counties have not only struggled with paying for the costs of mental health but also providing adequate care. The only area facility, Ellsworth Municipal Hospital, closed its mental ward in 2011 because budgets had been slashed by state government funding. Going regional last July further aggravated the case load because adequate funding did not accompany the change in law. A current report shows that Hardin County expenditure is !0% mental health ($1,958,192), intergovernmental revenue is 35%, and county revenue is 39% property taxes.

The key thing to me is the idea that no one in this country should be made to suffer, lose their life, or bankrupt their economic future in order to have access to quality medical care. We are one of the richest countries in the world with fabulous standards of living widespread throughout our country. I am not a proponent of "socialism," but the hard facts are that as medical care prices have increased, it has put it out of the reach for most Americans without help from either insurance or the government. If anybody who is negatively commenting on this had cancer, but not the money to treat it, thus facing certain death, they might change their opinion quickly. Quite frankly if it meant that my taxes increased slightly to help pay for this, and I did not get to order out food as often, or could not buy an house with 3-4 bathrooms. (I have lived in the same house with 1 1/2 baths for 35 years) so be it. I do not know how Terry Brandstad, or people that support him, can sleep well at night knowing that his plan would disallow 10s of thousands of Iowans health care when it could be available with help from the federal level. Is their any decency left in our state or just a bunch of people yapping their individual politics!

A better idea to either expanding Medicaid or IowaCare would be to fully subsidize private health insurance for those who cannot afford it or have no income for one reason or another. There will always be those who lack the means to adequately help themselves, and not all of those people are lazy freeloaders, but the governor's as of yet light on details plan to expand IowaCare appears to be an even more expensive option that will cover fewer uninsured people, something we don't need.

BTW, even this administration admits their intervention is increasing costs, not decreasing them as promised.

http://www.humanevents.com/2013/03/27/hhs-secretary-finally-admits-obamacare-is-raising-insurance-costs/

"Just letting the "free market" do what it wants, sans any regulation or rules won't necessarily help health care consumers." First of all, I didn't say "no regulation". Regulation should only be as minimal as possible and for as short a time period as possible. What we have today is a system where regulation is added and added and added, and each addition is more costs for health care companies as they have to comply with that regulation. It all drives costs up. Government needs to apply the existing laws consistently across everyone, so that businesses know they will get in deep trouble if they break the law.

Second, why wouldn't it help? Companies can only stay in business if they provide products or services that people want and can afford. People want quality services for an affordable price. Competition for health care dollars is already there, we just need to get government out of the way so costs can be lowered.

"For instance, if we just let the private sector go on denying those with pre-existing conditions access to affordable private health insurance, that's only going to cost those who ARE insured more by way of the uninsured seeking care in emergency rooms, thus increasing insurance premiums for those who are insured." You mean like what is happening now? Lori, the reason things are getting more and more expensive is because government is forcing more people's insurance to be paid for by you and me. If people know they are accountable and responsible for the consequences of their own decisions with respect to eating and exercise and taking care of themselves, they will be much more judicious at doing it. That will help everyone, and it can only be done by the individual choice of private citizens. Government cannot force us to eat better or drink better or exercise more. People have to do that themselves.

"Like it or not, there are times when the government stepping in (ie mandating insurance companies cover the aforementioned people) can help consumers, even if it cuts into profits for insurance companies." So let insurance companies figure out their own solutions, and let them sell these polices across state lines. Do you really think that Americans couldn't figure out how to make that work if they were allowed to?

"The private sector has had plenty of time to fix its problems with the health care system in this country, and it's failed miserably all on it's own." When have they, Lori? For the last 50 years they have been told what to do by a government that forces them down the path that government wants. When has the private sector had a chance to fix itself? It is so heavily regulated it can't do anything without government approval, and the government isn't approving the changes that need to happen.

Government run health care doesn't work, plain and simple.

Most anytime the government is offering something for free, its a bad idea. Iowa can fend for itself, no government needed here.

Per medical expenditures, costs keep rising because a) technology advances, and patients often demand the latest tests, even if they don't need them, and b) the more people who are for some reason locked out of the insurance market, the more who will come to rely on places like ERs for their care, causing premiums to rise for those who ARE insured when the uninsured cannot pay their medical bills.

You want to blame government regulations for this mess, Rick, but I stand firm that it's chiefly the health insurance companies who are to game for the mess they're in.

The government has really lowered medical costs. All you have to look at is how much medicare actually pays the doctor or medical facility when it is all said and done. Here are some actual examples: Out patient X-ray charge $75, Medicare approved amount $41.91, Radiologists charge $66, Medicare approved amount $10.05, Outpatient medical care $88.06, Medicare approved amount, $46.76. These are just a few examples. If our country went to a single payer system if be so much more efficient. If you have ever been through Mayo Clinic you would also see what efficiency is. After your initial forms you fill out you never have to do it again during your visit even if you go to a dozen clinics. It is all in the computer. In only a few hours your last visit to a doctor is on computer when you see your next doctor if needed. I have actually spent as long as 1 1/2 hours with a doctor and their charge is only around $150. Medicare usually pays everything they submit. One of the goals of the Obama Administration has been to ultimately get medical cost under control. If that does not happen, the main reason is because the opposing party made them make so many changes and concessions that Obamacare is only a whisper of what it could have been.

I have not heard any complaints about costs or coverage from the retired people I know. I pay for both medicare and a supplemental policy. I have excellent service and coverage. I keep hearing people worrying about the Government "taking over" healthcare and how awful that would be. I would say the government is doing a pretty good job containing costs and providing service with Medicare. It seems to be working well and I would have no qualms about expanding it for all. As I look at the new lavish hospitals being built I don't think the hospitals are hurting for money. The costs for simple supplies are quite extravagant. I think it is apprporiate to negotiate a lower price. The same applies for prescription prices.