Budget Cuts, Medicaid Mess Preventing Real Progress This Year

The opening day ceremonies and speeches are over and the 2018 Iowa General Assembly is well underway.

The most pressing issue facing the Legislature this year will be more budget cuts. In her Condition of the State Speech, Gov. Kim Reynolds proposed some $19 million dollars in cuts to Iowa’s universities, prisons and the Department of Human Services.

Among other things, the cuts will probably mean higher tuition for Iowa students and their families. In a fairly short period of time, Iowa has gone from a budget surplus to a budget nightmare, despite a growing economy.

An issue of particular interest to me this session is what’s been called the “Medicaid Mess.”

Two years ago, the Reynolds administration turned Iowa’s Medicaid program over to for-profit, out-of-state corporations.  Since then, service providers have gone unpaid, patients have lost services and Iowa taxpayers may be on the hook for higher costs.

The Reynolds administration imposed this Medicaid program on Iowa without any input from your elected representatives. Recently, many Republicans have joined Democrats in calling for change in the Medicaid program. In her speech, the governor herself conceded “mistakes were made” in privatizing Medicaid, but did not offer any concrete plans for changes.

Sen. Matt McCoy and I have been working between sessions on a bill to turn Medicaid back to state control and create a new public health insurance option for Iowans to purchase on the individual marketplace. Iowans who currently receive financial assistance on the marketplace would still be eligible to receive it. Our proposal is called “Healthy Iowans for a Public Option.” House File 2002 is assigned to the Commerce Committee. It has more than 20 co-sponsors. Will Republicans sign on? Do they have any ideas of their own to help providers, patients and taxpayers? We will find out over the next 100 days what — if anything — they are prepared to do.

Also this session I will continue to focus on the major health issue of prescription drug abuse. We will be working with the Iowa Pharmacy Association and the medical community to make the prescription drug monitoring program more effective in monitoring the use of controlled substances in our state.

Opioid abuse is the No. 1 public health issue in America and we must act.


by Representative John Forbes
Posted 1/17/18

4 Comments on "Budget Cuts, Medicaid Mess Preventing Real Progress This Year"

  • Absolutely agree, Rep. Forbes. At this point, progress, real progress, would be just getting back to where we were several years ago. And that’s sad!
    It’s going to be hard to overcome Gov. Reynolds’ comment about Democrats being against progress in Iowa. That is not going to help, because she’s obviously not looking for solutions – only an agenda (whatever that is).
    Hope, however, springs eternal, and I sincerely hope the Dems can pull enough Republican Legislators over to support HF2002 and its counterpart, SF2013 in the Senate! And, perhaps some meaningful legislation addressing the opioid crisis? Please?

  • Gov. Reynolds shares her own experience with addiction and yet fails to include significant funding for drug treatment. She expresses the need for quality mental health treatment
    and fails to admit that It is often said that our prisons have become our mental health institutions. Every time she looks for a place to make cuts, the Iowa Department of Corrections is always on the list. The only increase in the IDOC budget request is for one million dollars for medications to treat those in our prisons who must have medications that are extremely expensive.
    So the cuts will have to come from the cost of treatment for mental health and substance abuse which are the very things most needed if we are to actually address the very serious problems in our society.

  • The decision to privatize Medicaid represented pure political power by the Branstad administration. They were warned about the disastrous consequences of this action, but did not seek any advice from the legislature or citizens. At this stage of the program, it appears that many Medicaid patients are being discriminated against and it may take a court decision to resolve this mess.

  • Need to identify a new revenue source for to pay for the huge unmet demand for mental health and drug treatment services. Legalization of Cannabis would generate an estimated $200 million EACH YEAR to fund a massive increase in these services and allowing a reduction in property taxes. Also need to repeal the tax credits, exemptions, and deductions that mainly benefit the rich and big business. We need to get creative in order to expand the safety net!

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