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medicaid expansion

The Courtney Report

Courtney Report

The Iowa Legislature is back in session. We are quite happy to once again turn a corner of this blog over to excerpts from the newsletter of State Senator Tom Courtney and occasionally others. The full newsletter can be read here.

CLASS SIZES WILL INCREASE IF SCHOOL FUNDING FALLS SHORT

Another year of inadequate state funding for K-12 schools will result in larger class sizes. That’s what school administrators tell us in a new survey.
Superintendents, principals and other school officials completed the survey in recent weeks to help us better understand the consequences of shortchanging public schools, and to determine the impact of the Governor’s veto last summer of bipartisan school funding.

Underfunding local schools limits educational opportunity for our students. That’s bad for Iowa’s future at a time when business leaders say Iowa needs more skilled workers just to fill current job openings. When we underfund education, we undermine our state’s economy and the ability of Iowa families to get ahead.

In addition to packing more students into classrooms, school leaders say underfunding schools will force them to:

* Delay purchasing books and classroom materials (77 percent of respondents).
* Leave positions unfilled (71 percent).
* Delay new technology purchases (56 percent).
* Cut back on programs that help kids learn to read (43 percent).

An increase of at least 4 percent in basic state aid to schools is what’s needed for the next school year to avoid these types of drastic cuts, according 88 percent of school leaders who responded to the survey.

It’s time to make public schools a bipartisan priority of the Legislature again. We can afford to do it. Our state savings accounts are full at $719 million. That’s a record high level, equal 10 percent of state budget. In addition, we expect to end the year with a surplus of $264 million.

To view complete results from the school administrator survey, go to here.


IOWANS NERVOUS ABOUT MEDICAID PRIVATIZATION

Medicaid is the health care safety net for 560,000 Iowans. One in five Iowans depends on Medicaid for vital health care services, including the elderly, people with disabilities and mental health concerns, children and moms.

Because of an ill-conceived and poorly executed plan by the Branstad/Reynolds Administration, Iowa families may not be able to count on that safety net anymore.

The Governor’s unilateral decision to turn Medicaid and $4.2 billion over to a few private out-of-state companies is fiscally irresponsible and risky to the health of Iowans. The federal Centers for Medicare & Medicaid Services has stepped in to slow down the process until at least March 1, but many are still concerned that the Iowa Department of Human Services and the out-of-state companies will be not be prepared to make the transition by then.

Members, caregivers and families are in turmoil over the major changes to Iowa Medicaid. It could result in increased costs to taxpayers and denial of health care to Iowans. Some providers are unsure they’ll survive the new payment structure.

We will continue to help Iowa patients and local community health care providers as best we can with their individual circumstances.

In addition, Senate Democrats are developing stronger oversight legislation this session. We want safeguards in place to protect Iowans who rely on Medicaid and our local health care providers from potential negative impacts of privatizing Medicaid.

IOWA VETERANS DESERVE OUR SUPPORT
Veterans from across Iowa visited the State Capitol on January 20 for the annual Veterans Day on the Hill. I was pleased to welcome veterans from our district, and to listen to their concerns and ideas.

They had a full schedule of activities, including a special ceremony in the rotunda honoring their service. In addition they had the opportunity to meet Adjutant General Timothy Orr of the Iowa National Guard, Commandant Jodi Tymeson of the Iowa Veterans Home in Marshalltown, Iowa Department of Veterans Affairs Executive Director Col. Robert King (Ret.), and members of the Iowa Commission of Veterans Affairs.

The Legislature’s Veterans Affairs Committee has worked in a bipartisan way to expand benefits for our veterans, service members and their families. For example, last year we:

* Provided a stable source of revenue for the Iowa Veterans Trust Fund by transferring $2.5 million in lottery revenues each year to the trust fund (SF 323).
* Offered flexibility in using college aid by providing a total of 120 undergraduate credit hours through the National Guard Educational Assistance Program, instead of administering aid by term (SF 130).
* Expanded college credit for military education, training and experience to include National Guard members and Reservists, saving them time and money in completing their degrees (HF 205).
* Ensured a full property tax exemption through the Disabled Veterans Property Tax Credit to veterans who have 100 percent service-connected, permanent disability that makes it impossible to work (HF 166).
* Added “service-disabled veteran” to the definition of targeted small businesses, which are eligible for low-interest loans and grants, as well as consideration when that state seeks bids for goods and services (SF 499).

This year, we continue to explore opportunities to support our veterans, enhance existing services at the state and county levels, help returning service members reenter civilian life, and encourage more veterans to make Iowa their home.

Iowa troops who have answered the call to duty deserve this dedicated support.

Feds Wisely Delay Iowa’s Medicaid Privatization‏

Courtney Report

The decision by the federal Centers for Medicare & Medicaid Services (CMS) last week to delay privatization of Iowa’s Medicaid program is a victory for Medicaid recipients and providers.

Thousands of Iowans have been telling us this for months: the Branstad/Reynolds privatization plan attempts to do too much, too fast, and fails to protect vulnerable Iowans.

A letter from CMS Director Vikki Wachino states: “CMS previously outlined the requirements to provide high quality, accessible care to Medicaid beneficiaries, and Iowa has not yet met those requirements, meaning that a transition on January 1 would risk serious disruptions in care for Iowa Medicaid beneficiaries.”

Specific concerns raised by CMS include:

* Arbitrary and unrealistic implementation timeline
* Failure to establish adequate provider networks in advance
* Disruptions of longstanding patient-provider relationships
* Diminished quality and access to health care services
* Compromised patient care
* Inadequate communication with patients and providers

Despite the 60-day delay, the fight is not over. Hundreds of thousands of Iowans and their providers are still struggling to make sense of the changes the Governor is making to their health care. We must find a way to minimize the harm being imposed on Iowa families and health care providers.

Read the complete letter from CMS here.
Comment:

Sadly this is only a delay. The CMS is disposed toward eventually approving this plan. Therefore please contact any Iowa Senate Democrat to let them know you stand behind their opposition.

Branstad’s Record: Broken Promises and Handouts To Buddies

Gano holds Branstad accountable

Gano holds Branstad accountable

A few days back, Terry Branstad became America’s longest serving governor. But that certainly does not imply that he has in any way been the most consequential governor in America nor in Iowa. What it does say is that the vaunted, highly educated Iowa electorate tends to reelect candidates no matter what they do, especially if they are Republican.

Branstad’s recent terms have been exercises in taking our tax money and handing it over to his donors. Nothing could be more illustrative of this than the fiasco his administration has created in his haste to reward corporate donors from the insurance world with lucrative no-bid contracts to run Iowa’s Medicaid system. But here are many other examples from Orascom to his administrations ‘reinterpretation’ of tax laws to greatly benefit businesses.

Progress Iowa has created a website to keep track of Branstad’s broken promises. We can fully expect the millions of dollars in savings that Branstad promised that profitizing Medicaid would create will be on that list next year.

In a press release announcing their new website to track Branstad’s record of broken promises Matt Sinovic stated:

“Unfortunately, simply serving in office longer than any other governor in our country’s history is by far the most notable achievement of this governor’s administration,” said Matt Sinovic, Progress Iowa Executive Director. “They failed to keep a number of promises, from failing to create jobs to letting Iowa fall behind the rest of the country when it comes to supporting our students. They’ve done a good job staying in office, but a poor job serving their constituents.”

We echo Mr. Sinovic’s sentiments.

Great Examples Of Why The Internet Must Remain Free

keep the internet free
Would We Have Heard Of These Without An Open Net?

Boy, for a group of folks who spend most of their life pointing fingers and saying how much government sucks, Republicans sure can milk the the tax dollars for their personal wealth.

Sweetheart deals have been discovered involving former Iowa Republican officials in recent months. Matt Strawn, former Iowa GOP chair, has been awarded over $300,000 in no-bid contracts for his services by the University of Iowa over a period of years. In many of these cases, Strawn’s company did not even perform the work instead simply sub-contracting it to other firms. Mechanisms were employed to ensure the contracts were no-bid.

In a similar vein, former Iowa Speaker of the House, Kraig Paulsen was hired for a newly created and highly paid position at Iowa State University. The position built around what is billed as a “supply chain initiative” was created and then Paulsen picked to fill it without the usual practice of advertising the opening or screening candidates.

Paulsen was selected:

“His skills and experiences are considered a perfect fit for the College of Business initiative,” McCarroll said in an email to The Gazette. “His hire resulted from mutual interest and conversations about what the college wants to accomplish.”

In other words the process that was employed to let contracts to Matt Strawn’s firm at the U of Iowa was nearly exactly the same as the process employed to hire Speaker Paulsen at a substantial cost at Iowa State. An excellent analysis here:

Now let’s add into the mix the process to hire U of Iowa J. Bruce Harreld last summer.The president of Iowa’s Board of Regents, Bruce Rastetter essentially recruited Harreld for the job. Then the Board selected Harreld over other apparently more highly qualified candidates. While herald may not be the republican Party insider type that Strawn or Paulsen are, Regent’s Board Chair Bruce Rastetter surely is. Rastetter’s handling of the search for a new president looks almost like he hiring of Paulsen or the contracting of Strawn. Rastetter recruited and the picked Harreld with only the superficial appearance of a true hiring process.

In another vein, Iowa Governor for life Terry Branstad unilaterally dismantled the current Medicaid system and handed the lucrative contracts to run the system to hand picked companies.The upshot of Branstad’s unilateral move will be more money taken from our tax dollars and handed to wealthy corporations while those who were supposed to be helped by the Medicaid system – some nearly 600,000 Iowans – will receive poorer services.

There are two lessons to be learned through these stories. The very first is the corruption that is rampant in Iowa’s government at the moment. At a time when Terry Branstad is being hailed for his longevity as governor those who take government seriously are gnashing their teeth at how low Iowa government has fallen. Iowa was once the model for the country of how good governments should be run. Now Iowa is fast becoming a symbol of how state governments run by tea party zealots such as Sam Brownback or Scott Walker can fail its citizens.

The other lesson that has been unspoken is the value of the internet in providing a platform for such stories of corruption to be reported and analyzed by both a professional press and citizens alike. Were the internet to be transformed into a gatekeeper system as corporations and Republicans have been fighting for day in and day out, the possibility of stories such as these examples of the corruption of our state government would be hard to find and even harder to put together. Stories such as police brutality that has been buried for decades would remain buried were the internet to be put behind pay curtains.

Americans already pay premium dollars for internet access. Other countries in the free world have learned the value that an open internet has. Putting gatekeepers and pay curtains in charge of America’s internet wouldn’t be much different than the Chinese government’s control over their internet. Once in charge, someone will be selecting what stories citizens should not be allowed to read. happens every time.

Ernst, Grassley Vote To Take Away Health Care

joni ernst the perfect Koch investment

not working for most Iowans

not working for most Iowans

Also vote to gut Planned Parenthood

On a Senate vote using the reconciliation process to push a very bad Republican budget bill with amendments to dismantle the ACA (aka Obamacare) and to defund Planned Parenthood, Iowa’s two current Republican senators stood four square with their party and against the wishes of Iowans as they voted for the bill.

Were the President to sign this bill (very unlikely) some 17 million Americans could lose their health care and some 10 million women would be without affordable health services from Planned Parenthood.

Once again our Republican senators ignore the will of Iowans and vote for the interests of their wealthy donors and the extremist fringe elements of their party.

No Republican has yet to offer any replacement for the ACA nor has any offered any realistic alternatives for the services that Planned Parenthood offers women.

planned parentood attack

Senators Mathis, Ragan, Jochum Go To Washington To Stop Branstad

Sen.  Mathis

Sen. Mathis

Sen. Ragan

Sen. Ragan

Hats off to Iowa state Senators Liz Mathis of Cedar Rapids, Amanda Ragan of Mason City and Senate president Pam Jochum of Dubuque for taking the fight against Governor Branstad’s raid on the Medicaid program in Iowa to Washington where the asked for the agency to slow or stop the march to profitizing.

There is a finite pie of money that the Branstad administration is trying to reslice and give a large chunk to his buddies in the managed care plan business. Since the pie is finite, the only place the money going to the for-profit administrators could come from is part of the pie that is now going for health care. Somehow Branstad claims that this will be a win for those receiving Medicaid. The Branstad administration has done no analysis to show how the pie will be redistributed, they are simply in a huge hurry to turn the $4.2 billion in the program over to his buddies to run before anyone realizes they have been robbed.

Branstad was re-elected by Iowans last year despite numerous scandals. Since his reelection he has gone into hyper drive in his mission to give taxpayer money to friends of the Republican party in business. Unlike Scott Walker in Wisconsin or Rick Snyder in Michigan where the legislatures make laws to funnel the tax payer’s money to their donors, Branstad has to deal with Democrats controlling one house of the legislature who are unwilling to do his bidding. Thus Branstad is left to creating bogus executive actions to redirect money to their donors. So we have interpretation of tax laws that make no sense and a redistribution of Medicaid funds to give 3rd party administrators a big slice.

So a big thank you to Iowa’s Democrats for pulling out all the stops to see to it that Medicaid funds go to those who the funds were meant for – those who need help to get health care. Also a big thank you to the Iowa Hospitals Association which has filed a lawsuit to stop the headlong dive into making Medicaid much less workable.

Tuning in to a Medicaid listening session being held by the Centers for Medicare and Medicaid Services (CMS) Thursday it became obvious very quickly that there has been very little planning by the Branstad Administration beyond cutting checks to the managed care plan companies. Calls were received from a broad cross section of people and organizations that deal with Iowa’s Medicaid program. From every corner the message was quite clear that the Branstad Administration’s only planning has been in the area of giving our money to the managed care people. One participant noted that the MCOs (managed care organizations) have been guaranteed 15% off the top. What a waste!

(side note – sounds like Branstad plans as well as George W did going in to Iraq. Just do it and everything will be alright. Now we have ISIL.)

Branstad’s recent power grabs on school funding, closing mental health facilities, Medicaid, tax treatment for businesses and other areas must be challenged vigorously. What he and his administration are doing – setting up methods to funnel tax payer money to donors and cronies – is way beyond the pale. It is way past time that Iowans stop one of the Governor’s unethical and possibly illegal moves.

Our hats off also to those citizens who are standing up and saying a loud “NO!” to Branstad. This is what democracy is about. Standing up to the bullies who try to turn government into an income redistribution system from the poor to the rich. If we work together we can stop the railroading by the likes of Branstad, Walker, Snyder, or Rick Scott in Florida.

Even if Branstad is stopped on this front, what will be his next move to move our money to his cronies? This surely will not his last attempt. This is where a vigilant democracy comes into play.

Sen. Jochum

Sen. Jochum

Medicaid Listening Sessions

medicaidThe Centers for Medicare & Medicaid Services (CMS) will be hosting a series of Listening Sessions regarding Iowa’s High Quality Health Care Initiative. The initiative proposes to move Iowa’s delivery of most Medicaid services to a managed care delivery system effective January 1, 2016.

CMS must approve of the State’s proposal to move to a comprehensive Managed Care Delivery system.

There will be one more listening session targeted to Consumers and Advocates.

Consumers and Advocates  [Open to the general public]

November 19th 1:00 pm to 3:00 pm CST

Participant Toll-Free Dial-In Number: 1-800-837-19351-800-837-1935 FREE

Conference ID: 82231506

If you are aware of any individuals or organizations that may benefit from attending an upcoming session, please feel free to forward this invitation to them. To add an email address to the CMS Iowa Outreach contact list, please visit the following link to subscribe: https://public.govdelivery.com/accounts/USCMSMEDICAID/subscriber/new.

Although these listening sessions are meant for consumers and providers, they are open to the general public.

Rob Hogg: Medicaid Mess And More

Rob Hogg

Rob Hogg

Robb Hogg newsletter Nov.13

MEDICAID MESS

Governor Branstad’s current push to privatize Iowa Medicaid has upset many Iowans. Critics say it tries to do too much too fast, and is too disorganized, and does not accomplish any public benefit. Last month, I asked Governor Branstad to show the documentation on how this change would save money without cutting benefits or access to health care. He said he had no documentation.

I hope we can slow down or stop Governor Branstad’s proposal. If you agree, please take a moment today to sign a petition urging a six month delay until July 1, 2016. The petition can be found at www.IowansForQualityMedicaid.com.

Let’s take time to get this right.

CEDAR RIVER WATERSHED COALITION

I am attending the Cedar River Watershed Coalition meeting today in Waterloo, where the focus is on urban measures to reduce the risk of future flood damage. Although it has been more than seven years since the Flood of 2008, recent flood damage in South Carolina and Texas underscores the ongoing need for flood preparedness. If you would like to be involved in the Cedar River Watershed Coalition, please contact Mary Beth Stevenson at the Iowa Department of Natural Resources at marybeth.stevenson@dnr.iowa.gov.

CLIMATE SOLUTIONS TOUR

As part of a “climate solutions” tour, I visited facilities this week in Cedar Rapids (solar-powered electric vehicle charging stations), Pella (green buildings), Coon Rapids (land management), Carroll (solar-powered green building), Ames (biorenewable research), Decorah (solar power), and Charles City (ethanol plant and wind farm) to highlight the fact that climate solutions work for the environment and for our economy.

We need to act to address climate change, and the good news is we have solutions that work. Please speak up with federal and state elected officials to urge their support for public policy that promotes clean, home-grown renewable energy and other solutions to climate change.

INDEPENDENCE MHI VISIT

On Wednesday afternoon, November 18, I will be visiting the Independence Mental Health Institute as part of my service as chair of the Senate Government Oversight Committee. It is critical that we have facilities and programs that are working to meet the needs of our most vulnerable Iowans. I look forward to learning more about what the Independence MHI is doing and how it is serving the people of Iowa.

If Republicans Hate Government, Why Do They Run?

fugelsang republicans love government

Where ever two Republicans get together one topic of conversation is bound to be how bad the government is. The complaint is always too much government meddling in the wrong things. They almost sound anarchist in their desire to dismantle government. Yet they have built quite an election machine with the express purpose of running government from the schoolhouse to the White House and every stop in between.

The targets for their wrath over the years have been welfare programs, dismantling any social programs such as Social Security and Medicare and any regulatory programs.

Education has been one of the very biggest targets. What they have done to education is quite illustrative of why they really do not want to destroy government as their rhetoric would indicate. Rather than divorcing government from education, Republicans have come up with ingenious ways to milk federal dollars from the system and steer them to the wealthy.

Similarly Republicans see all levels of government as steering utilities that direct tax dollars from the poor and middle class to the elite – those captains and generals of industry who need an infusion of government dollars to be successful.

Iowans have one of the greatest examples of this going on right in front of their eyes with the actions of Terry Branstad in recent months. Vetoing money for schools one day and in the space of a couple months turning around to give businesses a tax break of almost equal cost, without even any input from the legislature. At nearly the same time, the governor created a method for private companies to siphon off dollars meant for the health care of Iowa’s poorest citizens and redirected it to private companies. And so money targeted for public good ends up in the pockets of private companies.

Thus Branstad illustrates how Republicans view government – it is an institution to be used to take from the poor and give to the rich using methods that can be created on the fly when needed.

IDP Statement on GOP Legislators Supporting Branstad Administration’s Disastrous Medicaid Privatization Plan

Iowa Democratic Party

DES MOINES – Today (Tuesday, Nov. 3), Republicans on the joint Health Care Policy Oversight Committee all voted against a motion to delay the Branstad administration’s disastrous Medicaid privatization plan by six months in response to concerns and unanswered questions about the change. Every Democrat on the Committee voted in support of the motion to delay the privatization plan.

In response, IDP Chair Dr. Andy McGuire issued the following statement:

“All across Iowa, health care professionals, caretakers and those who depend on Medicaid have expressed serious concerns with the Branstad-Reynolds administration’s privatization plan, including possible cuts to important services. Now with less than two months remaining until the privatization plan is set to take effect, the administration has failed to provide Iowans with crucial details into how the change will work, leaving Iowans with far more unanswered questions than answers. With the health and well being of more than 500,000 Iowans at stake, it is terribly disappointing that Republican lawmakers on the Oversight Committee would stand behind the Branstad-Reynolds administration’s disastrous privatization plan, and block a reasonable delay in implementing the change.

“I commend Democrats on the committee for standing up for vital health services that Iowans depend on.

“It’s time for the Branstad-Reynolds administration and Republicans in the legislature to listen to the people of Iowa and delay implementation of the Medicaid privatization until all concerns are addressed.”