MEDICAID/MANAGED CARE
On April 1, 2016, Iowa moved almost all of its Medicaid program to managed care - contracting with three private companies (Amerigroup, AmeriHealth Caritas, United) to manage the health and long-term care services provided to more than 550,000 low-income Iowans, older Iowans, and Iowans with disabilities.It's been a rocky transition, and one MCO (AmeriHealth Caritas) has already ended their contract with the state, effective December 1, 2017. The state has announced it will be bringing on at least one new MCO (Centene, aka "Total Care Iowa") for a startup date on July 1, 2019.
In addition, United Health announced it would be eventually ending the Integrated Health Home program for individuals who are not on habilitation or the children's mental health waiver (although legislative push-back ended in United calling a cease fire and agreeing to a hold until DHS could have more discussions with providers and review the health home system). The Legislative Health Policy Oversight Committee was created to make sure issues related to managed care are addressed quickly, but they have not met very often.
Iowa HealthLink (Medicaid Managed Care)
Resources on Managed Care
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REGIONAL MENTAL HEALTH/DISABILITY SERVICES
ID Action and the Iowa DD Council created several tools to help Iowans affected by disability better understand the impacts of the 2012 Mental Health and Disability Services Redesign on their services and supports and access. While the system has been redesigned, there continue to be signifcant challenges, including long-term funding stability. Previous legislation that gave local boards of supervisors the authority to set property taxes at the level they will need to be failed. Legislation to raise the state's sales tax by a penny, and dedicate a significant amount of money to buy out the locally-funded system and make it entirely state funded (but regionally managed) was discussed, but never introduced. In the 2018 session, legislators expanded the list of core services to be provided by regions to include ACT teams, Access Centers, and Intensive Rehabilitation Service Homes. Legislators also moved a long list of optional crisis services into the required "core" service category, but no new funds were identified to pay for the initial development of these programs, or the ongoing sustainability of the funding. Polk County Region, which has had an $8 million gap in funding for many years, was given the ability to shift money from other funding sources in fiscal year 2019 to cover shortfalls until a permanent solution can be found. The Legislative Council has been asked to approve an interim study to address long-term funding options (that decision will be made June 25, 2018).
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BUDGETS
The Iowa Legislature passes eleven budget bills each year. You can find the non-partisan legislative fiscal staff analysis of each of the fiscal year 2019 budgets passed by the Legislature here. These "NOBAs" (Notes On Bills and Amendments) give you a summary of the budget, spreadsheets, and the actual bill with notes from staff explaining each section. The 2019 Legislature will be approving fiscal year 2020 budgets later in the session, and these new budget documents will be listed at this link as well.