Two bills to address the impending privatization of Medicaid died in the Iowa House this week. Effective April 1, some 560,000 Iowans on Medicaid will have their health care services managed by one of three private insurance companies. Last month, three Republicans joined Iowa Senate Democrats to pass approved Senate File 2125, which would terminate the state's contracts with the managed care companies. Last week, six GOP senators voted with their Democratic colleagues for Senate File 2213, which would strengthen oversight of Medicaid by the Iowa Department of Human Services and the state legislature.
To stay alive after the Iowa legislature's second "funnel" deadline today, non-appropriations bills must have been passed by one chamber and by a committee in the other chamber. However, the bill to end privatization and the oversight bill both died in House Human Resources subcommittees. To my knowledge, the only bill related to Medicaid privatization that remains alive is Senate File 2260, which would prohibit the Iowa DHS from releasing to managed care organizations certain information about board members of non-profits that provide Medicaid services in Iowa.
Speaking to journalists yesterday, Iowa Senate President Pam Jochum described the House failure to act on the oversight and termination bills as a "disappointment" but added, "I can assure you the fight over Medicaid is not done. You will see the human services budget bill contain many of the measures that we believe are needed to protect Iowa's most vulnerable citizens." Click here for a detailed summary of the oversight bill's provisions. Maridith Morris described here how privatization will affect services available for her nephew on Medicaid.
House Speaker Linda Upmeyer told statehouse reporter Erin Murphy that Senate Democrats spent too long "working on killing the Medicaid modernization plan," while passing the oversight bill too close to the funnel deadline: "That's an 80-page bill that arrived very late last week. So we will look at oversight. We will work on oversight. But that bill just could not be managed in the time frame we were given. So we'll look at opportunities."
For the last five years of divided control at the statehouse, the human services budget has been one of the last bills to be resolved before lawmakers adjourn. Count on history to repeat itself this spring, because negotiations could drag on for months over Medicaid oversight and the near-certain Republican effort to eliminate Planned Parenthood funding for contraception services. A Bleeding Heartland post in progress will cover the family planning funding debate, as well as the fate of abortion-related legislation in the Iowa House and Senate this year.