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Health & Human Services Budgets Now Public

Monday, April 26, 2021

The Iowa House of Representatives and Iowa Senate have now made their budgets public, and they are about $22.3 million apart in the area of Health and Human Services (HHS).  Here is a quick review of the two bills (Senate File 606) and the unnumbered House Bill (it'll get a number when it passes out of the House Appropriations Committee later this week; this will be updated when that happens):

  • House increases Medicaid budget by $45.1 million; Senate adds $20 million.
    • House increases Home and Community Based Services (HCBS) waiver provider rates by 5.25% (total $11 million) and habilitation rates by $7.1 million.
    • Senate increases HCBS waiver and habilitation provider rates by $8 million total (about 3% increase for HCBS waiver rates).
    • Both House & Senate increase reimbursement rates for psychiatric medical institutions for children (PMIC) by $3.9 million (27.3% increase in rates).
    • House adds $20 million for nursing home reimbursement; the Senate adds $8 million and calls for a review of how nursing homes are reimbursed (called "rebasing").
  • House requires private insurance to pay the same for mental health services whether delivered in person or via telehealth (virtual visit), does not allow social worker and behavioral health boards from requiring supervision of beginning therapists to be in person, and allows individuals to gradually phase-out of child care assistance (rather than dropping off assistance suddenly when their wages increase).
  • Senate adds new asset test for Food Assistance (SNAP), including barring anyone from having more than one car, smart phones and other resources per household, and expands eligibility verification activities for all public assistance programs (Medicaid, SNAP, family assistance/FIP).
  • House allows Polk County Mental Health/Disability Services (MH/DS) Region to use other funds to avoid cuts in services; the Senate does not.

Notes on Bills and Amendments (NOBA for short) are mark-ups done by legislative budget staff to explain a budget bill. It has the bill on the left side of the page, with the explanation on the right side.  They are essential reading to anyone interested in this budget - lobbyists, staff, legislators, and advocates all use and depend on them!  You can see them at the links below (these links will be refreshed as the bills move through the process).

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