CHRISTIAN COALITION OF IOWA

LEGISLATIVE REPORT

    Norm Pawlewski – Lobbyist

    May 11 – May 16, 2005

            The legislature is still deadlocked over the budget.  House Republicans have refused to raise the cigarette tax, increase human services or education spending beyond what they have already appropriated.  House Speaker Christopher Rants said the differences between the House and Senate is $117.5 million and not the $25 million Democrats have said is the difference.  House Republicans are also concerned about the new programs started with these increases and their effects on future budgets.  There are estimates that future costs built into this budget could reach one half billion dollars or more. 

            Everybody is blaming Speaker Rants for the deadlock.  However, he still has only one vote; so there must be a lot of representatives supporting his position, maybe even a few House Democrats.  If you agree with Chris that an 8 per cent to 10 per cent increase in the state budget is too much, call your Representative and your Senator and tell them.  Encourage Representatives Chris Rants, Chuck Gipp and Bill Dix to hold the line on state spending and unneeded tax increases, even if that tax is popular with most voters.  Sin taxes are popular, unless of course it’s your sin they are taxing. 

            The Governor signed HF841, the Medicaid Reform Bill.  The Governor said, “In signing this legislation Iowa has the opportunity to be a leader in delivering health care services, particularly to the uninsured.  By working together we have prevented the loss of millions to Iowa’s Medicaid Program that would have likely meant a significant reduction in services to Iowa’s most vulnerable population.”  Wow! How about another chorus of “Zippity doo-dah”. 

            The reason the money was going to be lost is because Iowa and some other states were using some creative accounting to pull down more federal dollars than they should have.  The feds decided to close the loophole which allowed that to happen.  The Register in an editorial applauding the legislature and governor said: “So necessity became the mother of invention.  The new program will redirect state and local dollars previously used for health care to draw Iowa a bigger federal Medicaid match.”  Is that a new loophole I see? “ Iowa Department of Human Services Director Kevin Concannan calls it ‘making financial lemons out of lemonade’.”   The bill also includes a big and unpredictable expansion of health care to at least 30,000 Iowans who weren’t previously eligible.  These individuals will pay premiums based on income.  And of course, the ever elusive objective of implementing preventative health initiatives, such as incentives to quit smoking.  Hey! Won’t that reduce the amount of money the state hopes to make on increases in cigarette taxes?  What happens if after we have added 30 or 40 thousand new Medicaid recipients and the feds decide to close this loophole.  States are always trying to find ways to get the feds to pick up a greater share of Medicaid costs and the feds are always looking for ways to pay less.

            HF841 is a very complicated bill.  It does away with the Indigent Patient Program (usually referred to as the state papers program) which allowed indigent patients to be transported from their homes to the University of Iowa Medical Center.  It directs DHS to work to get people into home settings rather than nursing homes, offers services through Broadlawns (Polk Co.) Hospital, the University of Iowa Hospitals and Clinics and the state mental health hospitals.  Some people in these organizations and other health care providers were reluctant to endorse this legislation.  It is new, never been tried anywhere and poses unforeseen risks.  Hopefully it will all work out to Iowa’s benefit.  But the implementation of this legislation bears close scrutiny.  We will track this one and let you know if we got snookered again.