The Register's editorial

Sen. Matt McCoy and Rep. John Forbes are exactly right. Iowans who cannot find affordable, private health insurance should be able to buy into Medicaid coverage.

The proposal, unveiled last week by the two Democratic state lawmakers, is especially welcome now, as the state’s individual private insurance market is faltering.

Why not allow more Iowans — and the premiums they will pay — into an established government health insurance program that already insures more than 600,000 of their neighbors?

The proposal could offer an eventual lifeline to more than 70,000 Iowans who shop on their own for coverage without help from an employer. It would also repeal former Gov. Terry Branstad’s costly and disastrous privatization of Medicaid management.

Unfortunately, Republicans, who control the Iowa Legislature and governor’s office, immediately attacked the proposal.

“It’s a half-baked idea that hasn’t even worked in the most liberal of states,” said House Speaker Linda Upmeyer, R-Clear Lake.

What states would those be? Because when lawmakers in Nevada unveiled a similar idea this year, the problem was not the plan. It was politicians.

The Nevada Legislature passed a bill to offer Medicaid coverage alongside private health insurance on the state’s health insurance exchange. All residents could be covered. The state would need permission from the federal government, but the lawmaker who sponsored the bill said Washington officials were open to the idea.

Then Republican Gov. Brian Sandoval vetoed the legislation.

Upmeyer rightly notes details would need to be worked out for Medicaid to cover more Iowans. But the so-called “half-baked” idea is more than Republicans have in the oven. The majority party isn't offering any recipe for helping constituents.

Those constituents include Bill Zook, 57, of Ankeny. After retiring early and losing coverage through his employer, he bought a plan on his own from Wellmark Blue Cross & Blue Shield. He currently pays $1,458 per month for a policy with a $13,000 annual deductible.

But Wellmark is among the insurers exiting the individual market next year. A comparable policy from the only remaining insurer, Medica, will cost Zook and his wife about $2,400 per month, he said.

Zook is frustrated and took the time to travel to the Statehouse last week to hear what McCoy and Forbes were announcing. Now he and other Iowans should consider contacting Republican lawmakers and Gov. Kim Reynolds and telling them to support the idea of letting Iowans buy into Medicaid. Premiums could be based on income and would likely be much cheaper than private coverage.

That’s because Medicaid costs much less per beneficiary than private insurance. The program contains costs by using its market power to ratchet down reimbursements to health providers. It dedicates its money to paying for actual health care instead of shareholder dividends and CEO salaries.

State efforts to build on existing Medicaid could move the country toward a universal system of health insurance. It could create a desperately needed "public option" alternative to private coverage.

The government program already insures 75 million Americans.Created in 1965, Medicaid is a reliable insurer with an existing infrastructure in every state. It has low administrative costs and provides comprehensive benefits, including coverage for prescription drugs and hospitalization.

Three-fourths of the public, including a majority of Republicans, have a positive view of Medicaid, according to a recent poll from the Kaiser Family Foundation.

Most important, it is operated by the government. And the government will be there for Americans — even when private insurers jump ship or charge an Iowa couple $2,400 per month for health coverage.