End of Session
Throughout 2019 Session Democratic Lawmakers Push to Fix Medicaid Privatization
Throughout 2019 Session Democratic Lawmakers Push to Fix Medicaid Privatization
Ever since the Governor unilaterally privatized Medicaid in 2016, the results have been disastrous for the people of Iowa. Since this time, people have been systematically denied critical care, essential medical equipment, and have had their services severely reduced or cut altogether.
This year, lawmakers learned the situation will continue to get worse after UnitedHealthcare announced it would be leaving Iowa's managed care program this summer, which means 425,000 Iowans will be faced with another disruption to their health care.
UnitedHealthcare currently manages care for 70% of Iowans on Medicaid, taking on more members when AmeriHealth Caritas, another managed care organization (MCO), left the state in 2017. The departure of UnitedHealthCare leaves 425,000 Iowans facing another disruption in health care because many had just switched to UnitedHealthcare and have already had multiple case workers. This includes almost 237,000 children.
Iowa will only be left with two MCOs, Amerigroup and the newly contracted Iowa Total Care, to manage the Medicaid program. It has yet to be shown that these two MCOs will be able to handle the sudden influx of new members, and Iowa Total Care has not provided members with a list of providers that will be covered under their plan, further increasing the mass confusion.
In addition, other issues and concerns continue to plague Medicaid privatization. Many lawmakers are concerned the for-profit MCO’s will get another $150.3 million this fiscal year from the Reynolds Administration, including a bonus of $109 million and incentives worth $9.6 million. The MCO’s can keep up to 15% of taxpayer dollars to administer the program. Before privatization, just 4% of Medicaid dollars were spent on administration.
It has also been reported that the cost per member has risen by an annual average of 4.4% under managed care, but only increased an average of 1.5% under state management. The Medicaid budget was passed this year, but it did not include any funding for the MCO rate increases, which have yet to be released.
House Democrats are not the only ones worried about the privatization mess. In April this year, the federal government announced plans to investigate private Medicaid management companies, including those in Iowa. They are specifically investigating whether these MCOs are denying services and cutting care to those members they served. Those that called for the investigation directly cited Iowa’s managed care mess as an example of why this in-depth examination was necessary.
To help fix the Medicaid mess, House Democrats proposed several different solutions. However, Republican lawmakers refused to take any of them, and in some cases, wouldn’t even allow the bills to come up for debate. This mess will not fix itself, and until the GOP admits this privatization experiment is a complete failure, Iowa’s most vulnerable citizens will continue to suffer.
Politicization of Judicial Selection Process Passes Legislature
On the last day of session, Republican lawmakers approved a proposal to injected politics into the selection of Iowa judges. While the plan was opposed by a bi-partisan group of House members, it was still added to one of the final bills.
The proposal allows the Governor to have a majority of the input on the selection of Supreme Court and Appeals Court judges in the state. Currently, lawyers in the state and the Governor select an equal number of representatives to serve on the State Judicial Nominating Commission.
The Judicial Branch has one member on the commission. The commission then narrows a pool of potential judicial nominees and the Governor makes an appointment to the highest courts in the state. Under the new commission makeup, the Governor will always be able to appoint a majority of the commissioners that recommend potential nominees. The Governor then also gets the final say on which judge gets appointed.
Under the changes, judges are still required to be retained through regular elections. Judges in the state must face retention elections after regular intervals while serving. In these retention elections judges do not have an opponent, but instead must receive a majority of “yes” votes to maintain his or her position as a judge.
Governor Reynolds recently appointed her second selection during her tenure to the Iowa Supreme Court, Supreme Court Justice Christopher McDonald. Governor Reynolds appointed Justice Susan Christensen to the Iowa Supreme Court in 2018. The Iowa Supreme Court is composed of seven justices.
The Iowa Supreme Court is currently composed of five justices that have been appointed by Republican governors and two justices that have been appointed by Democratic governors.
Bill Limiting Local Spending Threatens IPERS
In the final days of session, the Legislature finalized a controversial bill that places arbitrary limits on local spending and could threaten the future of IPERS and other pensions for Iowans.
Under current law, local governments can fund pension obligations from a Trust and Agency Fund. The bill places this fund, along with several other government funds, under a new arbitrary cap within other funds. Putting several funds under the same cap would put funding for IPERS and other pensions for police and fire, called the 411 system, in competition with other city responsibilities like public safety, street repair, parks, trails, and libraries.
Senate File 634, which was approved on a party line vote, allows a local government to increase an annual budget above the 2% limit, but only with a supermajority vote of the local governing board. A minority of the members of the local governing board, either a board of supervisors or city council, could prohibit a city from increasing spending on city services for years. In addition, the bill has no consideration for new growth, so any area that is growing by more than 2% per year could be artificially constrained from increasing city services to meet the needs of these new areas.
The bill also has no exceptions for new facilities or services a local government may provide. For example, a city could approve a bond referendum to build a new library. The people in a city could overwhelmingly approve that referendum, but a minority of the city council could prevent additional funding to assure that there were librarians and support staff for the new building. This could leave a city having to cut other services just to staff the new library.
The bill now goes to the Governor to be signed or vetoed.
Medical Cannabidiol Expansion Moves Forward
More Iowans with severe health problems and chronic pain could have access to medicine that would improve their lives after a bi-partisan bill to expand the state’s medical cannabis law was approved.
In 2017, the Iowa Legislature expanded access to medical cannabis to Iowans suffering from the following medical conditions: cancer, multiple sclerosis, seizures, AIDS or HIV, Crohn’s disease, ALS, Parkinson’s disease, and other terminal diseases or untreatable pain. Currently, Iowa’s medical cannabis law is limited to the production of oils, capsules, and creams. Any production or sale of smokeable forms of marijuana is prohibited.
House File 732 was approved on the final day of session and will eliminate the current 3% THC cap and replace it with a 25 gram over 90-day period maximum disbursement. If signed in to law, the bill becomes effective immediately.
Currently, Iowa Relief and MedPharm are the only cannabis manufacturers licensed to operate within the state. MedPharm products opened in December at five licensed dispensaries, in Waterloo, Davenport, Council Bluffs, Windsor Heights, and Sioux City. As of the beginning of 2019, there were 505 health care professionals in Iowa who have patients certified for medical cannabidiol.
In a poll released earlier this year, nearly 80 percent of Iowans support expanding access to the state’s Medical Cannabidiol program, according to the Des Moines Register.
HF 732 now goes to the Governor for either a signature or a veto.
Lawmakers Throw Out 29 Legally Cast Ballots, Change Election Law
Iowa lawmakers made a change to election law that will result in more Iowans having their voices heard and their votes counted.
Iowa law currently allows for an absentee ballot to be counted if it is postmarked before Election Day. The only problem is the US Post Office cannot guarantee all mail receives a post mark, which leads to some ballots not being counted. To remedy this, some counties were using a postal tracking system to ensure ballots mailed on time were being counted, however a majority of counties were not.
To solve this issue, House Democrats lead a bipartisan effort requiring that all counties use a tracking system that will result in more absentee ballots being counted.
The law change came after a heated Election Contest, which saw 29 ballots thrown out. The Legislature decided early in the session not to count the votes of twenty-nine Iowans who legally and in good-faith cast absentee ballots in the 2018 General Election. On a party line vote, Republican lawmakers refused to count the ballots that were mailed in on time to the local county auditor and verified by the post office with a bar code, but did not contain a postmark. The vote came on the Election Contest filed in House District 55, which was decided by just nine votes.
On the recommendation of the Iowa Secretary of State, the local county auditor had refused to count the ballots after the November election, prompting the Election Contest. After a special Election Contest Committee was created, it met the first week of the session to hear opening arguments from each side’s representatives, but refused to hear from witnesses or listen to witness testimony even at the request of Democratic Lawmakers. The committee acted in direct violation of Iowa law which gives the person contesting the election the right to have the ballots opened and counted.
During House debate, Democratic lawmakers simply asked for the law to be followed and have the ballots counted, regardless of the outcome. Republican lawmakers refused to have the legally cast ballots counted and threw out the 29 ballots.
Despite the contentious Election Contest, some Republican lawmakers wanted to change the law to make it so even fewer ballots would be counted, but were ultimately unsuccessful in their voter suppression efforts.
School Infrastructure Funding Extended
After years of delays, a bill to improve school infrastructure, known as SAVE, was finally approved by lawmakers this session.
A top priority of school leaders across Iowa, the bill extends the one cent local sales tax for school infrastructure (SAVE) through 2051 instead of having it expire in 2031. The bill will continue to provide funds for school infrastructure improvements, as well as increasing a portion of the funds for property tax relief. A separate Career Academy competitive grant fund is established to help build job training facilities.
More transparency is also provided in the plan by allowing voters to reapprove the district’s revenue purpose statement. If SAVE funds are going to be obligated for 20 year bonds, school boards must hold a public hearing to give citizens an opportunity to petition for a direct vote of the people.
Children’s Mental Health System Created, Funding Still Unknown
Iowa did not have a mental health system specifically designed for children, until this session.
In April 2018, Gov. Reynolds signed an Executive Order creating the Children’s System State Board that was tasked with developing this system and laying out groundwork for future legislation. This session, lawmakers created an infrastructure for that system. The children’s system closely mirrors the adult mental health system that was created through legislation last year.
First, the bill identified what core services would be part of the children’s system. These services included prevention, early identification, education, behavioral health outpatient therapy, mobile response, crisis stabilization residential and community-based services, and a statewide 24-hour crisis hotline. The bill also made some changes to the Mental Health and Disability Services Regions Governing Board to help integrate the children’s system into the current adult system. Finally, the bill provided eligibility requirements for those who are able to receive these services.
The most important recommendation suggested by the Children’s System State Board was to find a stable funding source for this system. Unfortunately, no legislation this session addressed this issue. One-time funding to help some aspects of the system was found in the Health and Human Services Budget this year, but this was not a stable, continual source of revenue.
Funding is especially important because the mental health regions will be asked to fund most of this system without receiving any sort of financial assistance from the state. In fact, it is estimated that the regions will have to pay over $3.2 million in FY 2020 and $5 million in FY 2021 just for the children’s system alone. The regions are already required to fund the vast majority of the adult mental health system, and in order to truly make meaningful and lasting changes to children’s mental health, the services need to be fully-funded without depending entirely on one source.
Republican Lawmakers Show Budget Priorities, Rural Iowans Lose Out
As the Iowa Legislative Session came to a close and votes were cast on state budgets, it was clear that the priorities of the Majority Party were not to address the list of needs of Iowa’s rural communities. Republican lawmakers have controlled the Iowa House for almost a decade and they have created more hardships for Iowa’s rural cities and counties.
During Republican lawmaker’s control of the Iowa House, 71 of 99 counties have seen a population decline and Iowa’s rural communities earn $4.16 an hour less than Iowans who live in a metro area. The loss in population and low wages has led to a housing crisis and 1/5th of Iowa counties are actually losing homes.
As the budgets moved through both the Iowa House and Senate, Iowans living in rural Iowa deserve more than talking points and need real results. House Democrats continued the fight for budget priorities that impact all Iowans by raising wages and controlling health care costs.
Restoration of Felon Voting Rights Passes House
A bi-partisan plan to amend the Iowa Constitution and restore voting rights to some felons that have been convicted of crimes in Iowa passed the Iowa House this year. However, the bill was not taken up in the Senate this session. Under the rules of the Legislature, the amendment will still be eligible to be debated by the Senate next year.
House Joint Resolution 14 passed the Iowa House on a bipartisan vote of 95-2. The resolution would allow anyone convicted of a felony that has discharged his or her sentence to have the right to vote. Iowa currently prohibits anyone convicted of an “infamous crime,” which has been interpreted to mean most felonies, from voting without a restoration of the person’s rights.
Iowa and Kentucky are the only two states in the country that permanently prohibit felons from voting. There are currently about 50,000 people in the state of Iowa that have lost the right to vote because of a criminal record.
The only other way to restore the person’s rights under current Iowa law is for the Governor to do the restoration. Which means it does not require legislative action or amending the constitution.
The amendment would have to pass the Iowa Senate next year to have passed the current two year General Assembly. If the amendment then passed the next General Assembly, starting in January 2021, the amendment would be put before the voters on general election ballot in November 2022. If a majority of the voters approved the change the Iowa Constitution would be amended.
AARP Legislative Initiative Iowa Care Act Passes Legislature
A bi-partisan bill to help keep seniors in their homes longer and help address caregiver needs will become law later this year.
The Iowa Care Act is an AARP initiative designed to provide support to those that are caring for their loved ones after they are discharged from the hospital and are headed back home. The bill has three components to help caregivers:
1. Allows the patient to designate a caregiver, and have that caregiver’s name be recorded when the patient is admitted to a hospital.
2. The caregiver is to be informed when their loved one is admitted to the hospital or to be moved or discharged.
3. The caregiver is provided instruction of the medical tasks they will need to perform at home for their loved one, and gives them the opportunity to ask specific questions regarding these tasks.
Communication is very important in these critical situations, and the Care Act will help to lessen the confusion that many caregivers face when caring for their loved one.
For more information regarding the Care Act, please visit AARP’s website at: https://states.aarp.org/passing-iowa-care-act-top-priority-during-2019-legislative-session,.
School Transportation Investments Increased
Schools across Iowa are dealing with the rising costs of getting their students to school. Dollars spent on transportation costs reduce funding available for the classroom.
To address the rising costs, the Legislature approved $19 million to help schools address rising transportation costs, which is slated to help 185 school districts in Iowa.
The funding comes from the Transportation Equity Fund (TEF) to provide additional funding for transportation costs to school districts that exceed the statewide average. Consistent funding for transportation is addressed by creating a formula in the TEF that will be able to provide schools with funding every year, instead of relying on one time money for the Legislature.
Additional Help for Beginning Farmers
Iowans looking to start their life in farming will get a leg up under legislation passed by the Iowa Legislature. House File 768 doubles the tax credits available to beginning farmers from $6 to $12 million annually, modifies qualifications, and streamlines the process to better ensure that eligible Iowans access to the state’s world class farmland. The credits will be awarded on a first come first serve basis until the limit is reached The beginning farmer tax credit program incentivizes Iowa landowners to rent land to beginning farmers by issuing tax credits to the landowner to offset their individual or corporate tax liability. The credit the landowner receives is based on the agreement with the beginning farmer; whether the beginning farmer is paying cash rent or they have a commodity share agreement. So far, demand for the program has exceeded the supply of available credits, leaving beginning farmers unable to take advantage of the program.
In order to be eligible for the program, the beginning farmer must meet the requirements of the legislation, such as having sufficient education, training and experience in farming; being a resident of the state; having access to adequate working capital and production items; and that the participant will materially and substantially participate in the operation.
The agreement must be for at least two years and not more than five, and can be extended by the same terms if both sides agree. The assets cannot be leased or rented at a rate that is substantially higher than the market rate.
GOP Lawmakers Strip Powers from Iowa Attorney General
Both Senate and House Republican lawmakers voted to strip powers from Iowa’s Attorney General during this legislative session.
The partisan power grab, which was added to the Justice Systems Budget, will limit the Attorney General’s authority in legal matters. If signed into law, the Attorney General would be allowed to prosecute a case outside of Iowa only at the request of the Governor, the Executive Council, or the Legislature.
Since 2016, the Attorney General’s office has joined several federal lawsuits that mostly relate to consumer protection, anti-trust violations, and Medicaid fraud. They are designed to keep Iowans safe and hold bad actors accountable.
Several lawmakers offered a plan to keep the Iowa Attorney General independent and free of partisan influence from lawmakers and the Governor, but it was rejected on a party line vote.
The budget is currently being considered by the Governor, who has the authority to veto this section of the bill.
Supporting Iowa’s Veterans
This year, the Iowa Legislature continued to thank and support Iowa’s veterans and their families for the services and sacrifices they’ve made for our state and country.
Several bills were passed and sent to the Governor this session that will assist veterans across Iowa. One bill that was signed into law expands the number of families who are eligible to receive funds from the Injured Veterans Grants Program. This program provides funds to family members who have a loved one that was injured in a combat zone or contingency operation overseas. It allows families to travel to be with their injured soldier. Eligible families are able to receive $2,500 for travel expenses and an additional $2,500 for every 30 days their loved one is hospitalized.
This bill also eliminates barriers that military spouses may face when trying to obtain an occupational license or issues getting their work license expedited. Assisting military spouses with an easier transition with moving to Iowa will encourage more military members to stay in the state, or move to Iowa.
Finally, the Iowa Lottery continues to help our veterans by providing $2.5 million annually to the Iowa Veterans Trust Fund. Since 2008, the Iowa Lottery has given more than $27 million to the Fund. The Veterans Trust Fund provides assistance to qualified veterans for job training, education assistance, emergency housing and vehicle repairs, dental work, and durable medical equipment.
Iowa House Democrats will continue to support our veterans who have sacrificed so much for our state and nation.
2019 Natural Resources Update
This year, the Legislature passed a few bi-partisan bills relating to Iowa’s natural resources.
In the final days of session, lawmakers worked together to pass Logan’s Law, which was written in memory of Logan Luft, a 15 year old from Charles City , who was killed in an ATV accident in 2017. Before Logan passed away, he decided to be an organ donor and because of that decision five people received his organs.
After Logan passed away, his family learned of a bill in Minnesota that added organ donation tags on hunting and fishing licenses, just like the donor tags on a driver’s license. They contacted their State Representative and asked about Iowa doing the same thing. In response, a bill was sponsored in the Iowa House and Senate called Logan’s Law.
Logan’s law adds organ donor tags to hunting and fishing licenses and adds organ donation education to the hunter safety course. The law will increase awareness about organ donation and add an opportunity for people to sign up to be organ donors.
A few years ago, the Legislature passed legislation legalizing straight-walled cartridges. That legislation did not include nonambulatory hunters. This session a bill passed that would allow nonambulatory hunters to use the authorized method of take for each deer hunting season while fulfilling their any sex tag, which would allow them to use straight-walled cartridges.
Currently, the DNR hires companies to remove undesirable and invasive species of fish, also known as rough fish, from lakes. A bill passed this session mandates the DNR only use Iowa companies to remove the fish. Other states do not allow Iowa companies to provide the service in their states. This bill helps Iowa companies while keeping Iowa lakes maintained.
For more information regarding the hunting and fishing laws in Iowa and state parks, please visit the Iowa Department of Natural Resource’s website at http://www.iowadnr.gov.
Addressing Changing Transportation Technologies
Transportation technology is developing rapidly, and the Iowa Legislature took actions this session to adapt to these changes. The increasing use of electric vehicles and automated driving systems offer new opportunities for Iowans and Iowa businesses. But it also adds challenges for how we fund our road and bridges, and how to ensure the safety of systems on the road.
As of September 2018, there were 800 Battery Electric Vehicles registered in Iowa, double from the previous year. Additionally, there are another 1,900 Plug-In Hybrid Electric Vehicles.
In light of this increase the legislature directed the Iowa Department of Transportation (DOT) to estimate the impact of increased usage of electric, hybrid, and other high-efficiency motor vehicles on the future revenues to the road use tax fund. It also required the DOT to evaluate and recommend the creation of alternative funding mechanisms or the alteration of existing funding mechanisms to offset decreases in future revenues of the road use tax fund due to the increased use of electric, hybrid, and other high-efficiency motor vehicles. DOT produced recommendations with the goal no net change in revenue, equity and low administrative costs.
HF 767 was a result of these recommendations, including additional excise and use taxes on electric vehicles, electric battery hybrids, and hydrogen vehicles. The goal of the legislation is not to increase funding, but to simply maintain our current level.
Automated Driving Systems
The legislature this year also took the first steps in regulating automated driving systems, making sure that the roads remain safe in the face of rapidly evolving technologies.
House File 535 defines and regulates automated driving systems (ADS) in Iowa. The legislation details the tasks the systems must be able to perform to be able to operate in the state, insurance requirements, what to do in case of an accident, and how the vehicles must be properly operated. The operation and use of ADS equipped vehicles will be governed exclusively by the Department of Transportation. The legislation prohibits local governments from imposing requirements that exceed the requirements laid out in the legislation.
Whole Grade Sharing in Schools Extended
Lawmakers approved an extension of a program designed to encourage local schools to share resources and provide more opportunities for students. Called whole grade sharing, the program allows two or more school districts to share pupils in any grade for an educational program for all or a portion of a school day.
The program, which will be extended for another five years, is a crucial tool for rural schools districts and is an incentive for some to look at consolidation. School districts that participate in whole grade sharing and joint employment are eligible to can receive financial incentives from the state for up to three years. Additionally, if the school districts reorganize, they may be eligible to receive the supplementary weighting for a total of six years.
Legislature Takes First Step Towards Hemp Cultivation
Iowa farmers could have a new commodity when they are now allowed to grow, process, and sell hemp next year. Passing on a bi-partisan vote, the Iowa Hemp Act regulates the licensing and growing of industrial hemp. Hemp is defined as a species of cannabis that does not exceed three-tenths of 1% THC.
The legislation directs the Iowa Department of Agriculture and Land Stewardship (IDALS) to prepare a state plan and submit it to the United States Department of Agricultural (USDA). Once approved, IDALS assumes primary regulatory authority over the production of hemp.
Senate File 599 comes as a result of changes contained in the 2018 Farm Bill. The bill removed hemp from the Controlled Substances Act and allowed the USDA to issue regulations and guidance on the commercial production of industrial hemp. Under the law, states submit a plan to the USDA and must include certain requirements, such as keeping track of land, testing methods, and disposal of plants or products that exceed the allowed THC concentration.
IDALS will have oversight responsibility over industrial hemp and will establish and administer the hemp license applications. As a condition of licensure, consent is given to IDALS and the Department of Public Safety (DPS) or local law enforcement entering the crop site at any time. An individual can hold a number of licenses at one time but cannot cultivate more than 40 acres. Currently, 41 states have enacted legislation to establish industrial hemp cultivation and production programs.