Iowa is in the midst of a healthcare crisis – on multiple fronts.

The national discussion about the Affordable Care Act and the Trump administration’s active undermining of its provisions have left Iowans vulnerable and exposed to a volatile healthcare marketplace and the very real probability of not being able to afford coverage under the ACA. Trump’s administration is also entertaining the idea of allowing large companies to offer policies that don’t provide the basic coverage that the ACA currently requires and discontinues the preventative services Iowans have standard under their current policies.

Governor Reynolds is presiding over the Medicaid debacle in Iowa, leaving more than a half million vulnerable Iowans in unbearable situations. Many low income and disabled people have been denied critical services and many service providers have closed or gone deep into debt while waiting for payment of services by Iowa’s two remaining private Medicaid providers.

Iowa House and Senate Democrats have a plan to place Medicaid back under state control and create a “public option” for Iowans by allowing them to buy in to Medicaid. I support this plan, known as HIPO – Healthy Iowans for a Public Option. It would be administered by state employees and open to all Iowans. Senator Matt McCoy and Representative John Forbes are currently working on this plan.

Eventually, the Congress and the President will have to address the ACA and enhance it – or approve another system, such as Single Payer or Medicare for All. Until then, leaders in Iowa have a responsibility to offer our residents an option for coverage. Our hospitals and rural clinics are already seeing an increase in uninsured residents and the gains they made in providing care under the ACA are being lost.

I support all serious efforts on the state and federal level to provide health insurance to all Americans and I will work with both Democrats and Republicans to find a solution. I support reversing Iowa’s Medicaid privatization and returning to a state-run system with accountability and integrity. I want to put people first in this debate. We must get people covered. Healthcare is a necessity, not a privilege for the minority that are offered great coverage through their employers and can easily afford it. Even people with good insurance who get seriously ill risk medical bankruptcy.

Iowa is also failing to provide parity for mental health treatment and substance abuse treatment. You should not have to overdose or go to jail before accessing real help. We’ve transferred much of the burden to law enforcement and are using jails and emergency rooms inappropriately and shifting the costs to those institutions instead of providing much cheaper and much more effective community-based care.

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