Gov. Kim Reynolds today praised a new Trump administration Medicaid proposal in a release from her office. The guidance issued by the Centers for Medicare and Medicaid Services rips away the guarantee of coverage for adults and parents, allowing states to pick and choose who gets Medicaid coverage and what benefits they receive.
No matter what you call it—and you're likely to hear neutral phrases like “block grants” or “per capita caps”—it would equal less federal funding for Iowa and, in turn, fewer insured Iowans.
It also lets states change the rules on a whim, without having to seek federal approval or go through a transparent process that helps residents understand what’s at risk.
Adopting this scheme would do nothing to address the real health crises Iowa faces, including too few mental health services and the disappearance of obstetric care in parts of rural Iowa. But it could threaten the state’s ability to effectively respond in times of need like during an economic downturn, an epidemic like coronavirus, or a natural disaster.
Less funding equals less flexibility, period.
It's worth noting that legal experts raise serious questions about the proposal, which like other Administration regulations, guidance and waivers, tries to skirt federal Medicaid law and will likely result in costly litigation.
Given its innate flaws and the ongoing serious challenges our state already faces from privatized Medicaid, Iowans should reject this damaging approach.
Pricey and pointless
On the agenda at the state Capitol this week were bills that would have the state establish a complex quarterly eligibility verification system for Iowans enrolled in public assistance programs including Medicaid, SNAP (Food Assistance) and TANF (Family Investment Program).
Maintaining program integrity in our safety-net programs is a shared goal — as advocates, we want every dollar to go to families who need the help. But these bills are not a common-sense approach. They would lead to a pointless, pricey scheme that will increase bureaucratic red tape and administrative costs and make it harder for Iowans to stay healthy, put food on the table and support their families.
Take a deeper dive into where this legislation stands on this week's podcast:
Policy Associate Mary Nelle Trefz spoke at a House subcommittee meeting on one of those damaging eligibility verification bill Tuesday.
Let's talk taxes
Tax policy is going to be a big topic at the Capitol this session. Here are a couple of recent pieces that offer up some helpful context and history.
In the Quad City Times, the Iowa Policy Project's Mike Owen and David Osterberg break down the governor's flawed proposal to implement that 1-cent sales tax increase voters back in 2010. Wrote Owen and Osterberg:
“[T]he governor is agreeing to deliver on the voters’ consent to a tax increase only on the condition that she can cut other taxes by a greater amount. She wants unwarranted and significant cuts in the income tax that are guaranteed to hinder other services, from education to corrections to safety-net supports.”
Over at the Gazette, columnist Todd Dorman takes a hard look at Iowa’s numerous tax cuts—nearly $12.1 billion—over the past two decades and wonders why we’re still purportedly ranked 42nd in the nation for our business climate if tax cuts are such a magical boon to the economy. Noted Dorman:
“We could also try ignoring some Washington, D.C.-based think tank such as the Tax Foundation, which could not care less what kind of public schools and state universities we have, whether we can afford to provide mental health care and cover the cost of our justice, public health and child protection systems.”
Want to go deeper? Curious about the status of key bills? The Center maintains a bill tracker to outline the specific legislation we are following this this session.
Find your legislator
Not sure who represents you? With 50 senators and 100 representatives, it can be hard to keep tabs. Visit our Legislator Lookup tool to find out who represents you in the state house and senate, biographical information about each one and a link to their legislative websites, which list contact information and committee membership. All you need to do is enter your home address and zip code.