Policies & Issues

VOTER ID

The Governor signed HF 516 (Voter ID) into law, making Iowa the 33rd state to require some form of identification when voting, according to the National Conference of State Legislatures.  Seven states now require a photo ID in order to vote - a number that has doubled in the last five years.  Iowa's proposed law does not require a photo ID, and those without one will get a free voter card from the Secretary of State or their county auditor.  Click here to read more.

HEALTH CARE REFORM

Republicans in control of Congress and the White House vowed to "repeal and replace Obamacare."  Since the election, there have been a number of proposals and discussions around "block granting" Medicaid funding to states.  This is a huge shift in public policy, and Iowans with disabilities should start getting ready to talk about what they like and dislike about the current system - so that the new system can be designed to address them.  We will start collecting information on this here - so come back frequently.

NOTE: We are not endorsing the strategies in these articles; we simply would like you to see resources your lawmakers are probably looking at when thinking about heatlh reforms.  

• How States Can Shape ObamaCare Replacment (ALEC)
• 21st Century Cures: Deregulation & Investment will Modernize Healthcare (ALEC)
• State Laws & Actions Challenging Health Reforms (NCSL)
• Health Care Dollars from Data: How States Can Save Money (NCSL)

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.  Another, Amerigroup, has said they are not able to take on more clients at this time in order to make sure services to their existing clients remain stable.  The last MCO, 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 (althought the implementation of this was pushed back to Feb. 1, instead of December 1). The Legislative Health Policy Oversight Committee was created and has been meeting to make sure issues related to managed care are addressed quickly.  

• Read more about the Legislative Health Policy Oversight Committee. 
• Watch the work of the Medical Assistance Advisory Committee, which hosted monthly input sessions around the state.
• Check out who is on this committee here & read their bios here.
• See who is on the MAAC executive committee here.
• Access summaries from the public meetings conducted by MAAC on managed care here.
• Watch for meeting notices here.

Iowa HealthLink (Medicaid Managed Care)

• Click here to go the Iowa HealthLink website.
• Click here for the Medicaid modernization website.
• Click here for information for those receiving Medicaid-funded services (member information).
• Click here for information for Medicaid providers and other stakeholders.
• Click here for MCO comparison chart for value-added services.
• Click here for the most current DHS quarterly progress report evaluating MCOs.
• You can read more frequently asked questions here.

Resources on Managed Care

• Guiding Principles: Successfully Enrolling People with Disabilities in Managed Care Plans
• Analysis and Recommendations for Implementation of Managed Care for Medicaid and Medicare for People with Disabilities
• Ways to Implement Managed Care Without Hurting People with Disabilities

• Keeping Watch: Building State Capacity to Oversee Medicaid Managed Long Term Services and Supports
• Ready, Set, Go! The Readiness Review Process for Care Coordination and Provider Network Adequacy in Five States
• Consumer Choices and Continuity of Care in Managed Long Term Services and Supports: Emerging Practices and Lessons

• In Kansas, Fight Over Developmental Disability Services Shifting to Medicaid Managed Care (Kaiser Health News/Washington Post)
• Medicaid.gov state-by-state information on Medicaid managed care
• Managed Care in States (National Conference on State Legislatures, NCSL)
• Containing Medicaid Costs: Moving to Managed Care (NCSL)

__________________________________________________________________________________________________________

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. This year legislation will be introduced to allow local boards of supervisors the authority to set property taxes at the level they will need to be - so some counties can decrease their levies, and others (about eight) can raise them. Other legislation will be introduced 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). Check back for more details after the session begins.

• Click here for the most current map of the approved MH/DS Regions.
• Click here for MH/DS Region CEOs (region lead).
• Click here for MH/DS Regional Coordinators of Disability Services (county contacts).
• Click here to view waiting lists for services funded by regions (for FY16).
   
• Click here for the original Advocate's Guide to MH/DS Redesign (PDF). 
• Click here for the Update to the Advocate's Guide to MH/DS Redesign (PDF).
• Click here for a two-page "Quick Review" of the MH/DS Redesign (PDF).
• Click here to review our MH/DS Community Conversations Presentation.
• Click here to see the Regional Service Data report published every December 1.
• Click here to go to the Department of Human Services' Mental Health & Disability Services Regional Services website.

__________________________________________________________________________________________________________

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 2018 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.  Just make sure you use the most current version of these NOBAs!  

Governor Kim Reynolds will present her Fiscal Year 2019 budget in her first "Condition of the State" address on Tuesday, January 9, 2018 at 10 am.  The presentation will be broadcast live on Iowa Public Television and on Iowa Public Radio.  Check back here for information about her budget recommendations on January 9.