Iowa legislators should expect many more patients to sign up for a health care program for the poor if the state makes the program more convenient to use, a top administrator said Tuesday.
Lawmakers are considering changing the IowaCare program, which now can only be used at University of Iowa Hospitals in Iowa City or at Broadlawns Medical Center in Polk County. Possible changes include allowing patients to receive routine health care at safety-net clinics around the state, and allowing them to use local hospitals for emergency care. IowaCare serves poor adults who don't qualify for Medicaid because they don't have children. Jennifer Vermeer, who oversees the program for the Department of Human Services, told legislators it has 35,000 members. That's more than double the enrollment that was expected when the program was formed five years ago, she said. But another 100,000 Iowa adults qualify for the program, and many of them might sign up if it becomes easier to use, she said.
Such growth would cost millions of dollars, she said, and there's no guarantee that the federal government would help cover it. The program currently costs about $113 million per year, with the federal government picking up about two-thirds of expenses.
"Today, the program grows at a pretty good clip as it is," she said.
Offering service in more locations would increase costs by $21 million to $42 million, her agency estimated. She added that such predictions are hard to make without knowing how many extra patients would sign up for the program. The people now in it tend to be very poor and suffer from expensive, chronic illnesses. They also tend to be from central or eastern Iowa, because traveling from western Iowa is inconvenient.
Vermeer didn't voice opposition to making the program more convenient, but she said she wanted legislators to be aware of the possible outcome. She said if the program suddenly drew many more people without a great deal of new money, it might have to start waiting lists for service.
Vermeer's comments came at a meeting of the Legislature's joint health and human services appropriations subcommittee, which oversees spending on health care programs.
Sen. Jack Hatch, a Des Moines Democrat who is co-chairman of the committee, said afterward that the state could save money in the long run if it gets more uninsured people into regular, coordinated care.
"I'm trying to get people insured and healthier," he said. "I'm not trying to maintain the status quo."
Hatch noted that state officials have found a new way to attract more federal money for the cost of having University of Iowa doctors treat IowaCare patients. That should bring an extra $8 million for the hospital, plus another $8 million for the program, he said.
Sen. David Johnson of Ocheyedan, the Republicans' top-ranking senator on the committee, said in an interview that he understands the desire to make the program more convenient. His hometown is 340 miles from Iowa City, where his constituents have to go to get help under the current IowaCare program.
But Johnson noted the state faces huge challenges just to meet its current health care obligations. Those include the fast-rising costs of Medicaid and Hawk-I, which are much bigger health insurance programs.
Lawmakers are considering changing the IowaCare program, which now can only be used at University of Iowa Hospitals in Iowa City or at Broadlawns Medical Center in Polk County. Possible changes include allowing patients to receive routine health care at safety-net clinics around the state, and allowing them to use local hospitals for emergency care. IowaCare serves poor adults who don't qualify for Medicaid because they don't have children. Jennifer Vermeer, who oversees the program for the Department of Human Services, told legislators it has 35,000 members. That's more than double the enrollment that was expected when the program was formed five years ago, she said. But another 100,000 Iowa adults qualify for the program, and many of them might sign up if it becomes easier to use, she said.
Such growth would cost millions of dollars, she said, and there's no guarantee that the federal government would help cover it. The program currently costs about $113 million per year, with the federal government picking up about two-thirds of expenses.
"Today, the program grows at a pretty good clip as it is," she said.
Offering service in more locations would increase costs by $21 million to $42 million, her agency estimated. She added that such predictions are hard to make without knowing how many extra patients would sign up for the program. The people now in it tend to be very poor and suffer from expensive, chronic illnesses. They also tend to be from central or eastern Iowa, because traveling from western Iowa is inconvenient.
Vermeer didn't voice opposition to making the program more convenient, but she said she wanted legislators to be aware of the possible outcome. She said if the program suddenly drew many more people without a great deal of new money, it might have to start waiting lists for service.
Vermeer's comments came at a meeting of the Legislature's joint health and human services appropriations subcommittee, which oversees spending on health care programs.
Sen. Jack Hatch, a Des Moines Democrat who is co-chairman of the committee, said afterward that the state could save money in the long run if it gets more uninsured people into regular, coordinated care.
"I'm trying to get people insured and healthier," he said. "I'm not trying to maintain the status quo."
Hatch noted that state officials have found a new way to attract more federal money for the cost of having University of Iowa doctors treat IowaCare patients. That should bring an extra $8 million for the hospital, plus another $8 million for the program, he said.
Sen. David Johnson of Ocheyedan, the Republicans' top-ranking senator on the committee, said in an interview that he understands the desire to make the program more convenient. His hometown is 340 miles from Iowa City, where his constituents have to go to get help under the current IowaCare program.
But Johnson noted the state faces huge challenges just to meet its current health care obligations. Those include the fast-rising costs of Medicaid and Hawk-I, which are much bigger health insurance programs.
