Heading into the eighth week of session, the pace at the Iowa State Capitol is, if anything, more intense. We see some flickers of opportunity for Iowa children and their families, but quite a lots of threats. We continue updating our bill tracker to reflect the status of key bills. Bills in gray did not meet a procedural deadline ("funnel") to pass out of committee. So—although never say never because there are tricks to revive "dead" bills—they are likely done for the session.

A heads up to folks in north central and northeast Iowa: Gov. Kim Reynolds and Lt. Gov. Adam Gregg are hosting "Unleashing Opportunity" events in your neck of the woods this week. In-person events like these are a powerful opportunity to get some face time with—and your issues in front of—elected officials. Please consider attending if you can. Click on the city name to learn more and register.

1:30 p.m., Thursday, March 1: Webster City
2nd Street Emporium (615 Second St.)

8:00 a.m., Friday, March 2: Waukon
S&D Cafe (13 W. Main St.)

1:30 p.m., Friday, March 2: Waverly
East Bremer Diner (117 E. Bremer Ave.)

Below are three things of special note this week. 

Tax bill on fast track 

We could see floor debate on the Senate tax bill in the next few days. This legislation would—by its proponents' own estimates—cut $1 billion a year in revenue. Coming at a time of existing budget problems, it threatens critical Iowa services from child care and health care to education at all levels. 

There is simply no reason for such rapid action on this bill, which was released late last Wednesday, went to subcommittee at 8 a.m. Thursday and was approved by the full Ways & Means committee Thursday afternoon. (The Legislature is not in session on Fridays.)

Lawmakers have yet to fix this year’s budget shortfall. They should not rush into a tax plan that will inevitably lose the state even more money. And it will: there is simply no evidence of tax cuts paying for themselves. 

You’d think Iowa would learn from Kansas, where similarly dramatic tax cuts decimated the state budget and caused massive cuts to state services—all the while actually slowing, not adding to, economic growth in the state. Kansas lawmakers recently voted to end the experiment. 

"When confronted with the Kansas failure, the bill’s proponents respond that the only problem in Kansas was that they failed to cut services sufficiently to balance their budget,” noted Peter Fisher, research director of the Iowa Policy Project, in a blog post last week. “But here’s the problem: Their constituents were up in arms over the cuts they did enact; they would not have stood for anything more drastic."

Iowans have already felt the real-world consequences of falling revenue and the resulting cuts to education, human services and health care—and they don’t care for them. 

It’s also worth noting that as of midday Monday the Senate bill still does not have a fiscal note, a document prepared by the Legislative Services Agency to estimate the bill's fiscal impacts. The Senate is also slated to act before Iowa Revenue Estimating Conference releases its general fund revenue estimates for the balance of FY 18 (the current fiscal year that runs through June 30) and FY 19 next Friday.

This seems like bad idea, given that Iowa has repeatedly had to revise downward its budgets in recent years due to bad news from the REC. In fact, lawmakers have yet to act on a "deappropriations" bill to cut this year's budget following downward estimates released in December. 

Alex Howard, deputy director for the open-government group Sunlight Foundation, told AP reporter Barbara Rodriguez over the weekend there are reasons a bill can move swiftly in a state legislature with straightforward legislation under emergency circumstances, but that doesn't seem to be the case here.

"'The more complicated the legislation becomes and the more far-reaching it is, the more it makes sense to look at how much time there is for the public to fully understand and digest it,' he said.

Our message to lawmakers on tax cuts. 

Health insurance marketplace

We are watching with deep concern two bills advancing through the legislature that would take Iowa’s individual health insurance market backward. 

HF 2364 and SF 2329 would allow membership organizations to offer health benefit plans that are “deemed not to be insurance”—and therefore do not have to comply with state and federal regulations. Exempt from critical consumer protections, these plans could impose annual limits on coverage, exclude essential health benefits and deny coverage or charge higher prices based on pre-existing conditions. Skimpy plans like these would be less expensive, but unavailable or unhelpful to people with serious health concerns. If and when an enrollee did get sick, he or she would be left facing staggering costs.

By drawing younger, healthier people out of the state’s insurance exchange, these plans would further split Iowa’s individual insurance pool into two groups—one healthy and one less healthy—and lead insurers to increase premiums for the less healthy group. What Iowa actually needs is a single risk pool where costs are spread across a large group, making them manageable for everyone. 

This turn of events is all the more frustrating because after a period turmoil and uncertainty, Iowa’s individual marketplace has recently shown signs of stability:

  • Wellmark recently announced it plans to re-enter the marketplace in 2019

  • Despite major reductions in outreach efforts and an enrollment period that was cut in half, Iowa’s marketplace enrollment grew in 2018. 

These bills would blow up that progress. Instead of this dangerous step backwards, Iowa’s policymakers should adopt strategies that broaden the risk pool—improving outreach to enrollees, increasing subsidies and establishing reinsurance programs to help hold down premiums. 

Mental health 

Nearly three in four Iowans say mental health services in the state are a crisis or big problem, according to a poll conducted earlier this month for the Des Moines Register. We are pleased to see a slate of serious ideas that, if implemented effectively, would make real improvements in services available for adults. We are hoping for similarly serious approach to children’s mental health.

The Complex Service Needs Workgroup, assessing the needs of adults with complex mental health, disability and substance use disorder needs, made recommendations to the HHS Appropriations subcommittee earlier this month, including:

  • creating 11 more Assertive Community Treatment (ACT) Teams, which would bring the total number to 22. These teams provide individualized treatment and support in the home and community, including psychiatry, nursing and substance-use treatment. 

  • establishing six Access Centers to provide short-term crisis and residential services for individuals with a serious mental health and/or substance-use disorder requiring treatment, but not in an inpatient psychiatric hospital setting. 

Many of the Workgroup’s recommendations were incorporated into SF 2252, which passed out of committee last week. 

The Children’s Mental Health and Wellbeing Workgroup is expected to present its recommendations to HHS next week. Certainly there are Iowa children with complex mental-health needs to be met, but we will also be looking for strong emphasis on prevention and early-intervention services that address children’s mental health needs before a crisis occurs.

We also continue to watch SF 2113, which passed the Senate this week, and now goes to the House. This bill would require school personnel to undergo a one-hour training on suicide awareness and prevention as part of licensure. The bill represents a small but positive step forward for addressing the mental-health needs of youth. 

 

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. 

505 5th Ave., Ste. 404
Des Moines, IA 50309
(515) 280-9027 / www.cfpciowa.org

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