Physicians and Democrats stood outside of congressional offices in Davenport on Tuesday urging Iowa’s U.S. representatives and senators to extend health care tax credits and reverse their support for changes to Medicaid.
The federal government shut down began Oct. 1 because of an impasse between Democrats and Republicans in Congress over a short-term spending bill. Democrats want Republicans to extend Affordable Care Act subsidies first expanded during the pandemic that reduce health insurance costs for people covered by the marketplace and to reverse changes to Medicaid that were a part of the One Big Beautiful Bill.
Republicans say Democrats are holding the government hostage and that they should agree to pass a clean bill to fund the government and then negotiate on expiring health care subsidies.
Progressive groups are trying to put pressure on Republicans in more competitive districts, such as southeast Iowa’s 1st Congressional District, represented by U.S. Rep. Mariannette Miller-Meeks’ 1st Congressional District.
In downtown Davenport on Tuesday, Sue Dinsdale pointed to the expected rise in insurance premiums. The Iowa Insurance Division has posted on its website that premiums for marketplace-purchased health care carriers have filed for rate increases ranging from 12.6% to more than 25%.
Dinsdale warned that tens of thousands of Iowans could be priced out of their premiums and opt to go without health care if the subsidies are not extended.
“Thanks to Medicaid expansion, and the enhanced premium tax credits, the number of uninsured people has hit a record low over the last several years,” Dinsdale said.
Since the introduction of the enhanced premium tax credits, enrollment in the marketplace has more than doubled from about 11 to over 24 million people, the vast majority of who receive an enhanced premium tax credit, according to KFF.
KFF estimates the average premium will more than double if the tax credits are allowed to expire at the end of the year.
“This is health care in America right now,” Dinsdale said. “It’s complicated, frustrating, expensive, and now it’s precarious.”
Retired Quad-Cities physician Jim Kettlekamp said he saw firsthand the importance of the Affordable Care Act to his patients.
“I noticed an improvement in my patients’ access to health care. I could see my patients more regularly, which made it easier for me to monitor the effects of changes I made in my care,” Kettlekamp said. “Access to pharmacy benefits also allowed patients to afford medications that were previously out of their reach.”
For example, Kettlekamp said, before the Affordable Care Act some diabetes patients couldn’t afford newer formulations of insulin, which cost several hundred dollars per month without supplemental insurance. They had to rely on older forms of insulin, which may not have been very effective or as safe. With ACA subsidies, patients could afford better medications. Kettlekamp said he noticed the same thing with heart failure and high blood pressure medications.
“The benefits of good health insurance coverage were real and I saw them every day,” Kettlekamp said. “The ACA understood that it’s cheaper and better to do disease management in the clinic than in the hospital.”
In a call with reporters last week, Miller-Meeks called for reforms to health care that promoted competition, not “bailouts” for insurance companies.
“We need lower costs in health care. As a doctor, I know that. I’m working hard to lower costs in health care, to lower prescription drug costs,” she said. “But we need marketplace reforms — not bailouts to insurance companies and not bailouts to people making over $250,000 a year,” she said of Democrats’ push for an extension of enhanced tax credits created in 2021 under a federal COVID-19 relief package.
She said the Affordable Care Act has failed to control health care costs and that the extension of the enhanced tax credits would conceal “the increasing health care premiums, even for wealthy Americans.”
Tom Barton of The Gazette Des Moines Bureau contributed to this report.
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Sarah Watson
Davenport, Scott County, local politics
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