March 29, 2024

Budget negotiations

It’s budget negotiation time at the Capitol. Iowa lawmakers face complex decisions about how to distribute approximately $7 billion. Legislators owe the people of Iowa to be diligent in how we spend taxpayers’ dollars to ensure it is done efficiently. The Education and Administration and Regulations Appropriations budgets passed the House this week, and we’ve spent a good deal of time discussing the Infrastructure and the Health and Human Services Appropriations budgets.

The Health and Human Services budget funds the Departments of Aging, Human Resources (DHS), Public Health (IDPH) and Veterans Affairs. Some highlights of the House budget bill (HF766) include:

$12.1 million for the Iowa Department of Aging, an increase of $148,000 from last year; and an additional $27.4 million for nursing facility rebasing (recalculating rates based on new cost data).

The bill increases $11.06 million to the state’s children’s health insurance plan (HAWK-i); the bill also provides $338,000 to expand an existing Your Life Iowa statewide/24 hour hotline to include children’s mental health resources.

The proposal increases $1.5 million to the DHS field operations for more staff positions (about 29 full time) to relieve caseloads. Priority of these new positions will be related to child protection services and eligibility determination for low-income families. The budget would also increase $4.38 million to maintain the current 1,438 FTE positions.

There is also $550,000 allocated to IDPH for rural psychiatry training. Of that amount, $400,000 will be used for annual training of four psychiatric residents who will work in underserved areas of the state; the remaining money will provide psychiatric training to physician assistants and nurse practitioners. Another $250,000 is appropriated to Des Moines University for psychiatric training for physicians. This will be very helpful in increasing psychiatrists in our state to help those in need.

The Iowa Department of Veterans Affairs, including the Iowa Veterans Home is funded at $11.3 million from the general fund, which is an increase of $75,000 compared to last year’s budget.

The HHS budget increases are welcome and have some good appropriations. But there is a huge, blatant omission from majority party discussions concerning privatized Medicaid and its recent failures. The Medicaid privatization chaos is currently affecting more than 425,000 patients and many providers in Iowa. Hundreds of thousands of Iowans face major disruption to their health care after the announced withdrawal of MCO United Healthcare from Iowa Medicaid system. This week Democrats voted again for a plan to fix the problem by submitting two amendments to address the issues. Again, they were voted down. Trying times for patients and providers are all but guaranteed as two-thirds of Iowa’s Medicaid population is forced to switch insurance carriers again.

I continue to get heart-wrenching calls from constituents on how the Medicaid privatization is failing them and their loved ones. This must be fixed; we can no longer stand idly by and see our loved ones suffer. I have also been in conversations with our local providers and heard firsthand how the denied and rejected claims are impacting the services they provide. Please continue to reach out with your concerns.

Bill Watch HSB 165 — This bill is still in flux. I've received plenty of input this week about this House bill that would tie the hands of local governments' ability to fund pension plans, provide basic services and maintain infrastructure under the guise of property tax relief. I will watch and see how it looks when it comes to the floor of the House.