Sen. Jack Hatch, a Des Moines Democrat, said he's been talking with Republican Gov. Terry Branstad's chief of staff Jeff Boeyink, who has expressed willingness to assemble a summit organized by nonpartisan third parties.
Branstad's spokesman, Tim Albrecht, said the governor's office is interested in discussing such issues "but it would be premature to commit to any specific event until the decision had been rendered and we had adequate time to review its implications for Iowa."
Branstad, meanwhile, released a statement calling the court's ruling "a disastrous decision to uphold President Obama's destructive health care law" and is seeking to have it repealed. Republican legislative leaders claimed the law could lead to increased taxes as health insurance is offered to more people.
About 366,000 Iowans — roughly 12 percent of the population — are uninsured, according to U.S. Census Bureau data from 2011.
"Iowans are perfectly capable of making health care decisions on their own; they don't need Washington, D.C. telling them what to do," said Republican House Majority Leader Linda Upmeyer.
Iowa does not have a law establishing the new online health insurance markets required under the law. Called exchanges, the new markets are supposed to be up and running on Jan. 1, 2014. People buying coverage individually, as well as small businesses, will be able to shop for private coverage from a range of competing insurers.
Hatch said bringing together a variety of individuals and groups dealing with health care in a summit would help Iowa work through the law's complexities and meet the federal requirements. He said state officials have done some preparation and the state has received two federal grants totaling $8 million, one of which was used to help plan the exchange and another that helped the state comply with new electronic record-keeping requirements.
Branstad also signed a measure into law establishing a new licensing requirement for health insurance "navigators," to comply with the federal law. The navigators act like insurance agents to guide customers through the enrollment process.
Upmeyer said the state has enacted several other pieces of the health care law, including a website that helps Iowans buy insurance. But the website doesn't meet all the federal requirements, and Upmeyer said lawmakers would have to approve more legislation to comply.
While upholding most of the law, the court found problems with the expansion of Medicaid, although the majority of justices said the expansion could proceed as long as the federal government does not threaten to withhold states' entire Medicaid allotment if they don't take part in the law's expansion. The decision means states will not be forced to expand their Medicaid coverage under the law.
Hatch said Iowa Democrats in Iowa will push to expand Medicaid, a low-cost government health care program that covers low-income adults, children, people with disabilities and pregnant women.
"It would be a complete reversal and really a betrayal if Republicans wish to move the needle back," he said. "I assume there will be a lot of chest beating but we're going to proceed with covering as many adults as possible and expanding Medicaid."
About 150,000 additional people would be pulled into Medicaid if Iowa moves ahead with the expansion outlined under the federal law, said Roger Munns, spokesman for the Iowa Department of Human Services. Iowa currently enrolls about 400,000 people in Medicaid.
The federal overhaul allows adults with an income of less than 133 percent of the federal poverty level to be eligible for Medicaid. That means a single person making less than $14,856 would be eligible. Iowa currently enrolls children under age 18 with household income of less than 300 percent of poverty. That means a family of four making less than $30,657 would qualify.
Republican House Speaker Kraig Paulsen said he opposes government-run health care and said any talk of adding more people to Iowa's Medicaid roles is premature.
"I think right now what we're trying to do is make sure we have our arms around what we already do and make sure what we have is operating correctly and efficiently because I'm not 100 percent convinced that it is," he said.
He believes voters will express displeasure in the November election by electing Republicans to Congress and Mitt Romney to the White House. He suggested the law could then be overturned.
"I think the next step is we've got an intervening election," he said. "If it becomes part of the dialogue which I think it's going to, you know the electorate has a way of letting us know which way they want us to go."