Alerts
Iowa Medicaid to Manage AmeriHealth Members
11.27.17
Iowa Medicaid announced today that it will manage the care of 10,000 Iowans who had chosen Amerigroup as their managed care organization (MCO) before... Read More...
SENATE SPECIAL ELECTION SET: December 12
11.06.17
Last month, Senator Bill Anderson (R-Sioux City) announced he would be leaving the Senate.  Voters in Plymouth and parts of Woodbury County will go to... Read More...
ABLE CONTRIBUTIONS INCREASED
11.02.17
November 2, 2017.  The total annual contribution limit to an ABLE account will be increased from $14,000 per tax year to $15,000 per tax year... Read More...
AMERIHEALTH OUT OF MEDICAID MANAGED CARE
10.31.17
Nothing could be more scary on Halloween than more changes to Iowa's Medicaid managed care system.  Today is Halloween and two bits of bad news hit... Read More...
IOWA PULLS ITS STOP GAP PLAN
10.24.17
October 23, 2017.  As you may have heard by now, the Iowa Insurance Division has decided to pull the Stop Gap Plan proposal to help stabilize the... Read More...


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2017 ISSUE #9

Issue 9, September 13, 2017

Articles in This Issue:


NO SPECIAL SESSION

UPDATED 9/20/17.  Iowa finished its budget year on June 30, 2017.  Early in July, the news reported that our state may have overspent by $110 million.  Governor Kim Reynolds is only allowed to transfer up to $50 million if the state comes up short - but that would have only gotten us only halfway to a balanced budget.  Her only other option in the face of such a large shortfall is to call legislators back for a special budget-balancing special session.   

Many of our readers have been wondering why it took so long to make a decision on whether or not to call a special session.  Governor Kim Reynolds answered that question on September 20 - there will NOT be a special session.  We wanted to let you know why Iowa was able to "find" $100 million to close that gap.

  • Early estimates did show a big shortfall, but the state does not officially close its budget year books until the end of September.  A surprising amount of money continues to flow in and out of the state budget in these three months.
     
  • Most Iowans have a part of their paycheck withheld to pay for state income tax. The money withheld in the last half of June isn't due until July 10 - so it was not included in the early estimates.  Some smaller businesses send in sales taxes quarterly, so they sent in three months of sales tax collections in July.  According to the Legislative Services Agency, there was a big bump in revenue from this payment period that wasn't included in early estimates.
     
  • Businesses collect sales tax, but those sales taxes do not have to be sent into the state until the end of July 31.  Likewise, these revenues were not included in the early estimates.  
     
  • Tax collections are only one piece of the state's revenue.  The level of tax refunds paid out also impacts the final fiscal position of the state.  The amount of tax refunds paid out has been lower than expected.  That also was not included in early estimates.
     
  • State agencies also slowed down their spending during the last part of the year, so they didn't spend as much as expected.  Unspent funds are returned to the state's general fund.  The state expected state agencies would underspend by $5 million - returning that money to the state budget.  This number was also much larger.

In the end, Iowa will need to borrow $13 million from reserves to balance the budget, something the Governor can do without legislative approval.  But don't start dancing a jig just yet - legislators are very concerned about the current budget year (which started on July 1).  That likely means more budget cuts when legislators come back into their regular legislative session on Monday, January 8, 2018.

 
Worried about funding for Medicaid or other state-funded programs?  Use our message worksheet to get started, get tips on advocacy here, and send an email to your state legislators using our Grassroots Action Center.

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NO PARTY CHANGE IN SPECIAL ELECTIONS

It has been tough - impossible really - to keep our Guide to the Iowa Legislature updated this year! In the last 10 months, there have been four special elections, following the deaths of three legislators.  None of these elections changed the makeup of the Iowa House of Representatives or Iowa Senate.

Here's a quick recap:

  • Sen. Jim Lykam (D) replaced Joe Seng (D) - special election held 12/27/16
  • Rep. Monica Kurth (D) replaced Jim Lykam (who became Senator) - special election held 1/31/17
  • Rep. Jon Jacobsen (R) replaced Greg Forristall (R) - special election 6/27/17
  • Rep. Phil Miller (D) replaced Curt Hanson (D) - special election 8/8/17

We introduced our readers to Monica Kurth and Jim Lykam earlier this year, but we wanted to give you a chance to get to know our two newest legislators who were elected this summer.  
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Rep. Jon Jacobsen is a Republican and represents House District 22, which includes most of rural Pottawattamie County and some of the eastern part of Council Bluffs.  Rep. Jacobsen lives in Treynor and is a Senior Trust Officer and Vice President at Security National Bank in Council Bluffs.  Before that, we worked at Treynor State Bank (as Senior Vice President).  He has a law degree from the University of Iowa and co-hosted the weekly radio program, You Ain’t Heard Nothing (Saturday mornings on KMA radio).  For that work, he received 11 awards from the Iowa Broadcast News Association.

Jacobsen has a long history of community involvement, and has served as a member of the Council Bluffs Mercy Hospital Charitable Council, Treynor Optimists, President of the Cathedral Arts Project (a program to bring free access to fine arts to the public), Iowa Right to Life Committee, St. Albert’s liaison to the Catholic Schools Educational Board, Co-Chair of Boy Scouts of America Capital Campaign, Troop Committeeman for local Troop #729, President of the Council Bluffs Estate Planning Council, and member of the Grist Mill Theatre in Macedonia.

He has also been a long-time active member of the Pottawattamie County Republican Central Committee, served as moderator for Senate and Congressional debates, and as chair, delegate, and parliamentarian for Pottawattamie County Republican conventions.  Jacobsen and his wife Debra have three grown children, and are members of St. Cecilia’s Cathedral Church.  You can reach Rep. Jon Jacobsen by email (Jon.Jacobsen@legis.iowa.gov), by phone (402.452.3757), or by mail (103 Ehrig Avenue, Treynor, Iowa 51575). 

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Rep. Phil Miller is a Democrat who represents House District 82, which includes all of Davis and Van Buren Counties as well as the western part of Jefferson County (including Fairfield).  Rep. Miller lives in Fairfield and is a Doctor in Veterinary Medicine.  He works at The Veterinary Clinic, a large and small animal veterinary practice in Fairfield.  

Rep. Miller grew up on a family farm, was active in 4-H, received his degrees at Iowa State University, and continues to be active in the community.  He served as President of the Fairfield Community School District Board of Directors, is an active member of the First United Methodist Church, and served on the Jefferson County Board of Health.

Phil and his wife Connie (a school secretary at Washington Elementary School in Fairfield) have four adult children. IIn his free time, he enjoys reading, doing yard work, following Cyclone sports, and most of all, spending time with his grandchildren.  You can reach Rep. Phil Miller by email (Phil.Miller@legis.iowa.gov), by phone (641.472.2511), or by mail (902 S. Suncrest Drive, Fairfield, Iowa 52556).

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So, you are probably thinking (hoping) the special elections are over for the year.  Think again. Iowa's elected Secretary of Agriculture Bill Northey has been nominated for a top USDA job in Washington DC, and if confirmed by the Senate, will resign from his post with a little more than a year left in his term.  The Governor will appoint a replacement, and several on the rumored short list are legislators (Rep. Pat Grassley of New Hartford; Rep. Lee Hein of Monticello; Sen. Dan Zumbach of Ryan; Sen. Tim Kapucian of Keystone; former State Representative Annette Sweeney of Alden; Iowa Farm Bureau President Craig Hill; and Deputy Agriculture Secretary Mike Naig).  

Committee appointments will be updated later this year, and there will be some shuffling to accommodate the newly elected legislators this summer.  However, leaders may hold off on these assignments until they know if their will be more new faces joining them in 2018.  Stay tuned!

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CHANGES IN DHS LEADERSHIP

Since the November 2016 election, our state has seen new legislators sworn in after four special elections, our Lt. Governor taking over the role of Governor, and a new Lt. Governor being appointed.  As if this was not enough change in 11 months, there are rumors that our Secretary of Agricutlure will be appointed to a federal position and the Iowa Department of Human Services has changed its leadership team with a new Director, Deputy Director, and soon, new Medicaid Director.

NEW DIRECTOR OF DHS - JERRY FOXHOVEN.  Chuck Palmer served as the Director of the Iowa Department of Human Services (DHS) for nearly two decades - through the redesigns of the MH/DS system and the move to Medicaid managed care.  In June, Director Palmer retired and Governor Kim Reynolds made Jerry Foxhoven the new DHS Director.  

“Jerry Foxhoven is the compassionate, thoughtful leader we need serving in this important role,” Gov. Reynolds said. “DHS is on the front lines, working in all Iowa’s communities to ensure our state’s families are able to access the service and protection they expect and deserve. Jerry has the experience, qualification, respect and passion to excel in this demanding role.”

Prior to accepting this challenging job, Foxhoven served as executive director of Clinical Programs and Professor of Law at Drake University’s School of Law; director of the Joan & Lyle Middleton Center for Children’s Rights, a state and national advocacy center focusing on children’s rights issues;  and Administrator of the Iowa Child Advocacy Board, where he oversaw the Court Appointed Special Advocate (CASA) and Iowa Citizen Foster Care Review Board programs.  

“I have spent my life defending and protecting the rights of others,” Foxhoven said. “To do so in this elevated position is a challenge I humbly accept. I look forward to building trust and relationships in all 99 counties, working on behalf of all Iowans as we work together to solve the challenges many Iowa families are facing each day.”

Foxhoven may be familiar to many of our readers.  He co-chaired the Children’s Mental Health and Well-Being Workgroup, was a member of the Children Disabilities Services Workgroup (part of the 2013 MH/DS Redesign), and was a governing board member of Kidsake (a special needs adoption project).  He is a 1974 graduate of Morningside College, and earned his law degree from Drake University in 1977.  He lives in Clive with his wife, Julie.  

NEW DHS DEPUTY DIRECTOR - MIKKI STIER.   Weeks after Chuck Palmer retired, his long-time Deputy Director Sally Titus announced she too would retire.  Titus had been with the agency since 1979, and became Deputy Director in 1989, serving under five directors.  Mikki Stier (pronounced "steer") was named the new Deputy Director soon after.  Stier had been Medicaid Director since 2015 and will continue to oversee the program until a new director is found after a national search.

As Medicaid Director, Stier managed Iowa’s $5.6 billion Medicaid program.  Prior to joining DHS two years ago, Stier was the Vice President for External Affairs at Broadlawns Medicaid Center, where she built a network of business leaders and legislators to support the hospital’s operations.  Before that she was Executive Director of Home Health and Community Services at Iowa Health Systems (now UnityPoint) and President/CEO of InTrust (not-for-profit in-home health agency that was also a part of Iowa Health Systems).  She also served in leadership roles in several other hospitals around the country.  She serves on a number of local and national boards and twice received the American College of Healthcare Executives Service Award (2008, 2011).

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NEW CANNABIDIOL BOARD APPOINTED

The Iowa Legislature expanded Iowa's limited cannabidiol program earlier this year, allowing Iowans with several painful conditions to access legal cannabidiol, and allowing this cannabis oil to be made and sold in Iowa.  This will take some time to be fully implemented, but the Governor took the first step last month by appointing eight members to the board that will oversee the roll-out.  They are:

The board can recommend adding or removing medical conditions and is expected to work with state officials on creating the new manufacturing system.  Iowa still bans smoking marijuana, vaporizing it or eating cannabis-infused food.  

The Governor's office still must appoint one additional physician to the board - a physician with a specialty in gastroenterology knowledgeable about the use of medical cannabidiol.  You can read more about the board, and find out when it will meet, at idph.iowa.gov/mcarcp/meetings.  The next meeting is October 27 at the Iowa Laboratory Facility, DMACC Ankeny Campus, 2240 DMACC Blvd. (Room 208).

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UNDERSTANDING IOWA’S NEW VOTER LAWS

Iowa will become the 34th state to require its voters show some form of ID before voting when a bill passed earlier this year goes into full effect.  In Iowa, voter IDs will not be required until January 1, 2018. However, here is a list of other changes that may affect how you vote in this November's city and county elections.

  • Voters who are not registered to vote in the precinct where they live will need to show proof of residence, as well as identification, when they vote at the polling place.  

  • Someone who vouches for a person registering and voting on Election Day must show an ID and must live in the precinct where the new voter is casting a ballot. Voters who register and vote on Election Day must show proof of residency that is current within 45 days (like a current lease or a recent utility bill).  While new voters have always had to show proof of residency, they could bring in older documents.

  • Voters who register and vote on Election Day at polling places that do not have electronic pollbooks will cast provisional ballots. These voters do not have to return to the auditor’s office with additional documentation after they cast their ballots.  This is an additional step to give auditors time to confirm the voter is eligible to vote, something electronic pollbooks can do at the polling site.  

Right now Iowa's voter ID laws are going through the rules writing process.  After laws are passed, state agencies must write rules to explain how they are going to implement the laws.  In this case, the Secretary of State has filed rules for consideration and they are currently out for public comment.

  • You can read rule changes requested by the Secretary of State here and the Voter Registration Commission here.  
     
  • Iowans can comment on these proposed rules until September 19, 2017.  Written suggestions or comments should be sent to:  Eric Gookin, Election Administrator, Office of the Secretary of State, First Floor, Lucas State Office Building, Des Moines, Iowa 50319.  You can also call and leave comments at: (515) 281-0145.
  • A public hearing on the rules will be held on October 16, 2017 at 3 p.m. at the Secretary of State’s Office on the first floor of the Lucas State Office Building, 321 East 12th Street, Des Moines, Iowa. 

Stay tuned to infonetiowa.org - we will post the comments submitted by the Iowa DD Council when they are finalized, and provide a review of the proposed rules.  In addition, ID Action will continue to provide training opportunities on these news laws once the rules that implement them are finalized.  If you have any questions about how the new voter changes may impact you, contact your county auditor or the Secretary of State:

  • Click here to contact your county auditor.
  • Call the Secretary of State's "Voter Hotline" at 888.SOS.VOTE (888.767.8683) or emailing sos@sos.iowa.gov.

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HEALTH INSURANCE FOR 72,000 IN LIMBO

Iowans who buy their health insurance through the "Obamacare" health insurance exchange are facing a 58% increase in premiums.  Only one company (Medica) continues to offer policies on the exchange to Iowans, and they say rates have to increase because they have lost money on these plans, and they are not sure that Congress will continue to provide the Obamacare subsidies that help them provide coverage to 72,000 Iowans.

Iowa's Insurance Commissioner (David Ommen) has asked the federal government to allow Iowa to use federal subsidies to make changes that will keep premiums down and potentially lure Wellmark back into the exchange, so Iowans have affordable choices.  This "Stop Gap Plan" uses existing state programs to help offset costs, so insurers like Medica do not have to worry about high-cost claims breaking the bank and making it impossible to keep premiums stable.  

Officials with the Insurance Division said the "Stop Gap" health coverage sold to consumers during the 2018 open enrollment period will be guaranteed issue, include all of the Affordable Care Act's Essential Health Benefits and any additional benefits required by Iowa law, and will protect consumers from annual and lifetime caps.

While Ommen asked the federal government to make its decision in July, the state is still waiting for an answer.  At the Administrative Rules Review Committee meeting on Tuesday, September 12, Ommen said he is "a lot less optimistic" about federal approval for the plan, but he will continue to move forward as if the plan were approved.  He is doing this because they are under a time crunch to get this done - open enrollment for 2018 plans starts November 1, 2017 and ends December 15, 2017.   Watch the website for alerts: www.infonetiowa.org/news/alerts/.

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SINGLE INTERIM COMMITTEE APPROVED

When legislators are faced with an issue too difficult to tackle in the five months of the legislative session, they will often request an "interim committee" be appointed to address it in more depth over the summer and fall months when things are quieter.  This year, only one interim was approved, dealing with the state's opioid crisis. While a meeting has not yet been set, committee members have been appointed.  You can keep track of this interim committee's work here.

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ABLE RESOURCES UPDATED

Iowans interested in setting up ABLE (Achieving a Better Life Experience) accounts can do so now in Iowa.  You can find all the information you need at www.iable.gov.  The ABLE National Resource Center also hosts regular online information sessions (webinars), and provides up to date information about options - www.ablenrc.org.

ABLE accounts allow individuals with disabilities to save up to $14,000 each year to help pay for education, transportation, housing, assistive technology, employment support and training, personal support services, health care expenses, and other "qualified disability expenses."  Family and friends can contribute to these accounts, without risking eligibility for Social Security and other government programs (including Medicaid).

As Rik Shannon, Public Policy Manager at the Iowa DD Council, explained after the creation of Iowa's ABLE program, “For a long time we’ve had federally imposed asset limits that serve as a roadblock toward financial independence for many people who live with a disability. This is a program that supports people with disabilities to live independently in communities of their choice.”

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REMINDER: Public Forums in the Interim

Legislators do not hold as many forums over the summer and fall, but your federal elected officials (Congress, US Senate) and the new Governor/Lt. Governor team are busy traveling the state.  Make sure you check our Calendar regulary to find these opportunities to talk with your elected officials!  Click here, or go directly to http://www.infonetiowa.org/calendar/events/.

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