Iowa Democrats trying to add autism insurance coverage to budget bill

Earlier this month, Claire Celsi informed Bleeding Heartland readers about the demise of an autism insurance bill after State Representative Peter Cownie refused to bring the measure up for a vote in the Iowa House Commerce Committee, which he chairs.

As both Autism Awareness Month and the 2016 legislative session wind down, Democrats in the Iowa House and Senate have been working to add the same requirements to a must-pass budget bill. Follow me after the jump for background and where things stand in this fight.

Continue Reading...

Prospects for increasing diversity in the Iowa legislature (post-filing edition)

Now that the deadline to compete in the Democratic or Republican primaries has passed, the field of candidates is set in most of the 100 Iowa House districts and 25 Iowa Senate districts that will be on the ballot this fall.

It’s time for a first look at chances to increase diversity in the state legislature for the next two years. The proportion of white lawmakers is unlikely to change, while the proportion of women could move in either direction.

Continue Reading...

Medicaid oversight bill passes Iowa Senate with bipartisan support

Since Terry Branstad returned to the governor’s office, the overwhelming majority of Iowa Senate votes on contentious political issues have fallen along strict party lines: 26 Democrats one way and 24 Republicans the opposite. However, the Branstad administration’s rush to privatize Medicaid has created space for bipartisanship, as a growing number of Republicans acknowledge the dangers of shifting to managed care for a program through which one in six Iowans access health services.

Last month, three GOP senators joined their Democratic colleagues to vote for a bill that would have halted Iowa’s Medicaid privatization. That legislation is going nowhere in the Republican-controlled state House, and federal officials recently approved waivers to allow the Iowa Department of Human Services to implement the managed care policy as of April 1.

Yesterday a quarter of the GOP state senators voted with all 26 Democrats for a Medicaid oversight bill that had cleared the Senate Human Resources Committee unanimously. In her remarks to open floor debate on Senate File 2213, Human Resources Committee Chair Amanda Ragan said the bill was designed "to safeguard the interests of Medicaid members, encourage the participation of Medicaid providers, and protect Iowa taxpayers." She told colleagues, "we must require DHS and the managed care companies to protect consumers, preserve provider networks, address the unique needs of children and assure accountability."

I enclose below highlights from the debate on SF 2213, the roll call on final passage, and Ragan’s full remarks, along with a Democratic staff analysis summarizing the bill’s key points.

Continue Reading...

IA-Sen: Patty Judge thinking about challenging Chuck Grassley

The Des Moines Register’s Jason Noble snagged a surprising scoop yesterday: former Lieutenant Governor and Iowa Secretary of Agriculture Patty Judge is considering running for the U.S. Senate this year. Referring to Grassley’s approach to the U.S. Supreme Court vacancy, Judge told Noble,

“Iowans have always been straight shooters, and up until the recent time I would have said the same thing about Chuck,” Judge said. […]

“I don’t like this double-speak,” Judge said. “I don’t like this deliberate obstruction of the process. I think Chuck Grassley owes us better. He’s been with us a long time. Maybe he’s been with us too long.”

To qualify for the Democratic primary ballot, Judge would need to submit nominating papers with the Secretary of State’s Office by March 18, three weeks from today. That doesn’t leave much time to collect at least 2,104 signatures, including minimum amounts in at least ten Iowa counties. But Judge could pull together a campaign quickly, having won three statewide elections—for secretary of agriculture in 1998 and 2002 and on the ticket with Chet Culver in 2006.

Three other Democrats are seeking the nomination to run against Grassley: State Senator Rob Hogg, former State Senator Tom Fiegen, and former State Representative Bob Krause. Former State Representative Ray Zirkelbach launched a U.S. Senate campaign in November but ended his campaign last month, Zirkelbach confirmed by phone this morning.

Dozens of Democratic state lawmakers endorsed Hogg in January. I enclose the full list below. Any comments about the Senate race are welcome in this thread.

UPDATE: Rebecca Tuetken notes, "Patty Judge does meet one apparent Iowa requirement: she told @SenatorHarkin ‘08 steak fry that she can castrate a calf." Truly a classic moment for Judge, when Joni Ernst was still the little-known Montgomery County auditor.

Continue Reading...

Feds approve Iowa's Medicaid privatization, effective April 1

Iowa’s Medicaid program will shift to managed care for some 560,000 recipients on April 1, in accordance with waivers granted by the federal Centers for Medicare and Medicaid Services. CMS had previously denied the request from Governor Terry Branstad’s administration to privatize Medicaid by January 1, citing numerous signs that the state was not ready. In a letter the Branstad administration released today, Vikki Wachino of CMS noted "significant improvement" in several areas: the provider networks of three insurance companies picked to manage care for Medicaid recipients; plans for reimbursing out-of-network providers for services; better communication between state officials and Medicaid providers and recipients; and training of case managers to assist Medicaid beneficiaries during the transition.

I enclose below reaction to today’s news from the governor, key state lawmakers, and other stakeholders, as well as the full five-page letter from CMS to Mikki Stier, director for Medicaid in the Iowa Department of Human Services. Federal officials set several conditions on their approval of Iowa’s plans, such as monitoring the actions of the three managed-care organizations, making sure call centers are running their helplines competently, and preserving some "continuity of care" for Medicaid recipients.

Although the delay until April 1 will allow more time to prepare for the transition, the policy’s likely impact remains the same: more money for insurance company overhead and profit and less for health care services; a deterioration in care for disabled people, as seen in Kansas and other states; and less access to health care providers (a key issue for the three Iowa Senate Republicans who recently voted with Democrats to terminate Medicaid privatization).

Senate Democrats continue to push for "tough, bipartisan oversight and accountability protections." Chelsea Keenan reported for the Cedar Rapids Gazette that the Senate Human Resources Committee will consider that bill (Senate File 2213) on February 24. I don’t expect that legislation to go anywhere. All I’ve heard from Iowa House Republicans is happy talk, backed up by no evidence, that privatizing Medicaid will save the state money and improve patient care.

Continue Reading...
View More...