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Iowa Watchdog

Daily Show’s Jon Stewart pokes fun at Iowa health care plans, whiffs on some facts


DES MOINES – Jon Stewart of “The Daily Show” Wednesday night took aim at 15 states, including Iowa, that have shunned free federal dollars to expand Medicaid and the number of poor people it covers.

The problem for the Comedy Central funnyman is that those dollars are anything but free and many doubt that the feds can keep their promises.

Under Obamacare, the federal government has offered to pick up almost the entire tab of the expanded programs, which will lead to a large increase in the number of low-income people covered.

“Seems like a no-brainer,” Stewart said on the show.

Stewart poked fun at Iowa on last night’s broadcast.

Stewart poked fun at Iowa on last night’s broadcast.


But then there’s the 15 “no brain” states, as he described them, that have turned down the federal government’s offer in exchange for their own programs.

Utah has proposed using charity. Texas wants a bag of money with no strings attached. And let’s not forget Tennessee, where they have the “Tennessee Standard Spend Down,” a lottery program that provides coverage to the first 2,500 callers. That figure compares to 330,000 people who would have been covered under the Medicaid expansion, Stewart said.

Then there’s Iowa, where optimism is the chief strategy in extending insurance coverage, Stewart said, before showing an interview clip of Gov. Terry Branstad.

“We have a better idea in Iowa,” Branstad said. “We are working for people to take ownership of their own health. We’re focusing on exercise and nutrition.”

Cut back to Stewart: “Right after we eat the world’s largest fried cow-lamb on a stick,” he said in reference to Iowa State Fair.

For much of Iowa’s 2013 legislative session Branstead fervently opposed Medicaid expansion, fearing that the federal government wouldn’t stand behind generous funding promises. As part of Medicaid expansion, the federal government will cover 100 percent of new-enrollee costs for the first three years before the rate slides down to 90 percent in 2019 and beyond.

“We want to make sure we protect the taxpayers of Iowa against the uncertainty of the federal government,” Branstad explained in a recent press conference, as reported by the Des Moines Register. 

In a deal struck with legislative Democrats near the session’s end, Branstad agreed to expand coverage to 150,000 low-income Iowans using the federal funds, but the compromise comes with two important caveats. First, the state can opt out of the expansion if the federal government can’t uphold its end of the bargain. Second, the state-run program will ask participants to make health decisions to reduce costs and improve outcomes.

Branstad is hardly the only governor in the land to express doubt about the federal government’s ability to pay its bills. Former Montana Gov. Brian Schweitzer, a Democrat, said in an October 2011 interview that expanding the Medicaid expansion puts his state at risk for bankruptcy.

“Unlike the federal government, Montana can’t just print money,’’ Schweitzer told the Boston Globe last year.

Schweitzer eventually decided to expand, a move that one analyst suggested have have stemmed from his political ambitions.

Many Republican legislators were hesitant to sign onto expansion. “Once Iowa decides to jump into Medicaid expansion with both feet, there is no backing out,” wrote state Rep. Kraig Paulsen, R-Hiawatha.

“We believe it is irresponsible and foolhardy to believe the federal government will live up to its funding promises.”

The federal government uses a slew of new and increased taxes — not a pot of free money — to fund Medicaid expansion.

Click here to see the Stewart clip. 

Contact Sheena Dooley at Sheena Dooley is the Iowa bureau chief for, where this story first appeared.

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