Capitol Update: Week 12

Medicaid Managed Care Begins April 1

After months of resistance by legislative Democrats in Iowa over the transition to managed care, the program will go live on April 1, 2016.

House Republicans have focused on how to make the system better and ensure that Medicaid recipients have all of the information they need to be confident in the change. However, Democrats have focused on scaring Medicaid members, telling them that their benefits will be gone and deaths will result from this change to managed care.

The status quo is no longer an acceptable option for Medicaid members or Iowa taxpayers because of skyrocketing costs in the program and the absence of accountability measures for health outcomes. The past year has been filled politically motivated rhetoric, discontent and resistance to change.  Despite perpetuating many of the scare tactics and fear pushed by Democrats, the media has managed to report a few success stories:

According to a report by America’s Health Insurance Plans, the following are examples of what managed care has done in other states:

  • New York City – Medicaid participants report better access to care than patients in the fee-for-service program and are more likely to have a regular source of care and to go to a doctor’s office rather than an emergency room
  • Rhode Island – Infant mortality rates have dropped from 4.5 deaths per 1,000 births to 1.9 per 1,000 since health plans began came into the state for Medicaid members.
  • Wisconsin – Children with asthma enrolled in managed care are less likely to require hospitalization than asthmatic children in the state’s fee-for-service program.
  • Oregon – Participation in treatment programs for substance abuse for people receiving care through health plans has increased nearly 40%.
  • California – Medicaid members enrolled in health plans were up to 38% less likely to have been hospitalized.

These are just a few examples of what managed care is able to do. The focus needs to be on ensuring that this program works for Iowans that need assistance during the transition.  In addition, there are safeguards in place for Medicaid members:

  • Medicaid members will be able to keep their current case manager until September 30, 2016.
  • Managed Care Organizations (MCOs) are required to continue current service plans until a new plan is created and agreed upon.
  • MCOs cannot reduce or modify a service plan without additional assessments.
  • MCOs have to ensure access to enrollees’ current prescriptions during the transition.
  • The state will monitor the MCO member services helplines to ensure timely and accurate information is available to beneficiaries.

Finding Committed Funding for Water Quality

The Ways & Means Committee introduced new legislation Tuesday to pay for programs to curb water pollution. HSB 654 would convert an existing 6 percent sales tax Iowans pay on their water bill for metered water into a 6 percent excise tax. The money would flow into a state fund for water quality initiatives that will help fund waste water and drinking water facilities.

Currently the sales tax is put into the General fund to be used for any purpose. The excise tax will redirect it to be used solely for water quality and the upgrading of water facilities.  I was a part of the subcommittee that held discussions on Thursday morning.  It also passed out of the Ways & Means full Committee later that day.

News from District 96

This week was very slow in the House. We were here on Monday; however, the Senate Democrat Leadership decided to not gavel in until Tuesday afternoon.  The Majority of their members went home Wednesday evening with little to nothing work accomplished for the week.  Once again we did not have agreed upon targets with the Senate.  If this continues the chances of finishing the session on time seems to be slipping away.  April 19th is quickly approaching and that is the official end of session this year.

I had the chance to discuss many constituent’s concerns this week. Pam Goodyear and I visited about the Iowa Health Care Association at their annual event.  I also chatted with Jim Grief from the Iowa Corn Growers about Water Quality and other issues.  Bruce Neiman and Kevin Glanz from the Delaware Farm Bureau were also in the Capitol this week and we review issues important to them.

U.S. Senator Ernst was in Des Moines this week and I briefly spoke with her on the CRP rent issue. The formula that sets CRP rental is not in line with current market conditions.  I suggested that she look into the issue to make the CRP formula more responsive.

I attended another bill signing ceremony this week. This bill was HF 2269 and it updates the code section which refers to the Beef Check-Off.  I was excited to be joined by members of the Cattleman’s Association at the bill signing.

As always if you have any questions feel free to get in touch. My phone number is (319) 480-1997 and my email is

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