(Radio Iowa) – A report from a private, independent research firm devoted to healthcare issues details what will happen in Iowa — and to Iowans — if Congress moves ahead with a plan to enact deep cuts to Medicaid. Rachel Nuzum, senior vice president of policy at the Commonwealth Fund, says some U-S House Republicans propose 880-billion dollars in cuts to Medicaid, which is the nation’s public health insurance program for low-income residents. “About 673,000 people are covered by Medicaid in Iowa,” Nuzum says, “and in Iowa, the Medicaid program is called Iowa Health Link. It really is the source for coverage for kids to see doctors, low-income older adults to afford prescriptions, and for families to really get the care that they need most. Thirty-eight percent of all children in Iowa are covered by Medicaid.”

In addition, about one in every two Iowa nursing home residents is covered by Medicaid. If Congress follows through with the cuts, the organization predicts it could result in nearly 900-thousand lost jobs nationwide and a 95-billion dollar drop in state gross domestic products next year alone. Nuzum says, “In Iowa specifically, this could mean $865-million in lost economic activity, over 33,000 jobs lost, and a reduction of $177-million in lost state and local revenue.” Under the current funding formula, the federal government pays 90-percent of Medicaid costs while states pay ten-percent, but Congress may decide to shake that up. “They could change that percentage for the expansion population. Iowa expanded Medicaid and there’s about 250,000 adults in the expansion group, so they could change the matching rate for that group alone,” Nuzum says. “They could impose work requirements that would really impact who is eligible for coverage.”

The State of Iowa has already asked the Trump Administration to approve a work requirement plan for some of the Iowa adults enrolled in Medicaid. Governor Kim Reynolds said it’s about “promoting a culture of work” among “able-bodied” adults under age of 65 who get government-paid insurance coverage. The waiver request would require at least 100 hours of work per month. Nuzum says the changes being proposed would be challenging for some people to accept. “We know that once people have benefits that they rely on, it’s really difficult to take that away,” Nuzum says. “In a lot of areas, especially rural areas, we already have shortages in our healthcare workforce. We already have hospitals that are really struggling to stay afloat financially.”

Medicaid is not just a health care program, she says, but a major economic engine in every state.