Iowa Senate Democrats

Fighting for a Better Deal for Iowans.

  • Feds launch investigative review of oversight of privatized Medicaid

    Iowa Senate News Release
    For Immediate Release:  April 17, 2019

     Key Iowa Senators applaud investigation by U.S. Inspector General

    DES MOINES – The U.S. Office of Inspector General has launched an investigative review of whether federal officials are providing sufficient and appropriate oversight to ensure that people with Medicaid are receiving the care to which they are entitled.

    Citing the lack of oversight of privatized Medicaid by Governor Reynolds and the Republican-controlled Legislature, two key Iowa State Senators today praised the new investigation.

    “Since it was launched three years ago in Iowa, privatized Medicaid has been unsustainable, unaffordable and unaccountable,” Senator Amanda Ragan of Mason City and Liz Mathis of Hiawatha wrote in a letter to U.S. Inspector General Daniel R. Levinson. “There has been little effort by the Governor or majority party in the Iowa General Assembly to provide proper oversight for the out-of-state managed care organizations (MCOs).”

    The Senators added: “Medicaid advocates, policymakers and other taxpayers deserve an investigation by the Inspector General that provides an answer to the question that we have asked since the start of Medicaid privatization in Iowa: Are some MCOs putting the bottom line ahead of patient health and safety?”

    The Inspector General initiated the review of the oversight role of the Centers for Medicare & Medicaid Services (CMS) at the request of U.S. Senator Robert Casey of Pennsylvania, Ranking Member of the Special Committee on Aging.

    In his request, Casey cited reports from across the country “alleging that some Medicaid managed care companies (MCOs) continuously deny care to patients sorely in need of care. In some cases, patients have experienced entirely preventable life-altering harms.”

    “Medicaid is emblematic of who we are as a nation, reflecting who we value and the ideals we are willing to fight for,” Casey added. “We must ensure Medicaid MCOs live up to these ideals and provide Americans with the health care that they deserve.”

    In its description of the investigation, the Inspector General acknowledges that privatized Medicaid “can create an incentive to deny beneficiaries’ access to covered services.”

    “Our review will determine whether Medicaid MCOs complied with Federal requirements when denying access to requested medical and dental services and drug prescriptions that required prior authorization,” the agency’s website states.

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    Links:

    Letter from Sens. Ragan and Mathis to Inspector General

    Inspector General’s website

    Letter from Senator Robert Casey to Inspector General

  • Don’t let Medicaid mess undermine children’s health insurance

    Iowa Senate News Release
    Senator Nate Boulton
    Representative John Forbes
    For Immediate Release:  April 15, 2019

     

    Don’t let Medicaid mess undermine Iowa’s successful children’s health insurance program

    Two members of the board of Hawki, Iowa’s nationally recognized Hawki children’s health insurance program, today raised concerns in a letter about maintaining quality as it becomes part of Iowa’s troubled privatized Medicaid program.

    “This is another challenging transition for Iowa families,” said Senator Nate Boulton.  “Unitedhealthcare had been a Hawki provider for more than five years.  Those families need as much support as possible to make sure their care is not interrupted.  Specifically, we must make sure providers continue to welcome Hawki kids into their care.”

    “The Hawki transition is another opportunity for the Reynolds Administration to show that it has learned from past mistakes,” said Representative John Forbes.  “Iowans were promised that a privatized health care system would increase quality and access to care. However, too often they have instead gotten more headaches and problems.”

    Hawki provides low-cost health coverage for more than 70,000 children from working families across the state.   The Hawki Board of Directors guides the Department of Human Services’ efforts to develop, implement and administer the Hawki program.

    The questions for the board included:

    • How will the Board/DHS communicate with Hawki families about the transition from UnitedHealthcare to one of the two remaining managed-care organizations, Amerigroup Iowa or Iowa Total Care?
    • How will the Board/DHS communicate with schools across the state to make sure that parents and school officials are aware of the upcoming changes?  This is especially concerning for parents/guardians because they will be scheduling annual physicals, immunizations and other routine care during the summer months.
    • How will parents/guardians learn whether they will be able to keep their current pediatrician or other health care provider if they are transitioning to Amerigroup Iowa or Iowa Total Care?
    • How will the Board/DHS ensure healthcare providers continue to see Hawki as a secure and trustworthy benefit program, one that they want to be involved with?

    -end-

  • Republicans once again turn their backs on suffering Iowans

    April 4, 2019

    Statement by Senator Joe Bolkcom

    Republicans voted today to continue to restrict access to THC in medical cannabis. Their decision means thousands of Iowans will continue suffer needlessly.

    Iowa is the only state with a comprehensive medical cannabis program that has limits on THC medicine. Iowa has the nation’s most restrictive, most unworkable, and least compassionate medical cannabis program.

    Iowans who want to fix our state’s broken medical cannabis program should contact their legislators, especially Republicans, before the Legislature adjourns.

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  • More problems for Iowa health care | Sign our petition

    Privatized, for-profit Medicaid continues to cause chaos and uncertainty for Iowa families, health care providers and taxpayers.

    On Friday, we learned that UnitedHealthcare is leaving Iowa’s managed care program. UnitedHealthcare currently is the MCO for over 70 percent of Iowans on Medicaid. That means 425,000 Iowans will again have their health care disrupted, as they are forced to switch insurance companies. This could put our most vulnerable in life or death situations.

    Governor Reynolds says that United HealthCare is unwilling to be held accountable for the quality of its services. United Healthcare claims they’re leaving due “to underfunding and the inability to create a path forward with sustainable funding.”

    Iowans are not interested in a “he said, she said” between MCOs and the Governor. The bottom line is that “three years into our costly Medicaid privatization experiment, Iowa’s dominant managed-care organization (MCO) still can’t handle normal business practices like paying health care providers on time.”

    This is just the latest in a series of problems that have plagued privatized Medicaid since its inception three years ago. Democrats have offered ideas for meaningful improvements—but time and again, they fall on deaf ears.

    Elected officials should listen to Iowans who depend on Medicaid, and to health care providers, family care givers and tax payers. Together, Iowans can fix our broken health care system. We can turn this problem into a success that will make our state healthier, stronger and a more attractive place to live.

    If you agree, please sign our petition and join Democratic lawmakers in calling on Statehouse Republicans to fix Iowa’s failed Medicaid privatization experiment. Go to iowansforqualitymedicaid.com to sign the petition—and share it with others who share our concerns!

  • What Iowans are saying

    Iowans want decent-paying jobs, affordable health care and the chance to lead a good life. In recent years, however, we’ve seen stagnant wages, rising health care costs and more Iowans living paycheck to paycheck. Iowans deserve better.

    In a survey earlier this session, Senate Democrats asked what you think can best help everyday Iowans. The table below summarizes your top responses.

    Many Iowans also shared their thoughts on how we can move Iowa forward. Here’s a sample of what you had to say:

    • Jobs – “Iowans I know are working two or more jobs without healthcare benefits to stay afloat. They live paycheck to paycheck with no financial reserves for something as basic as a car repair or an unexpected illness. Thousands of Iowans are barely surviving financially rather than living this wonderful middle class life we keep hearing about. This is true throughout the state and is deeply felt in rural Iowa.” –Mary from Ottumwa
    • Worker training – “Keep improving our community colleges, to expand the trade programs. Our state needs trained workers to fill jobs that are screaming for applicants.” –Ron from Eldridge
    • Rural Iowa – “We need to have more industry of all kinds and technology jobs in rural areas to improve economies of small towns so that people are not moving away to cities and out of state.” -Linda from Spencer
    • Health care – “I hear on a regular basis how parents have had to quit jobs to take care of disabled children. Patients are having to forgo medication because insurance won’t pay for it even if they have tried other medications or been on the medications for years.” –Melissa from Coralville
    • Education – “I’m a parent with a child in kindergarten and I substitute for the same school district, and from both sides, I can see the need to give more funds in education. Our children are the future, we should be giving them the best education we can and paying teacher’s a better wage too for all they deal with.” –Lisa from Clinton

    Thank you to all who offered their input. I am committed to Putting Iowans First by focusing on our shared values of fairness, compassion, dignity, equality and liberty.

    Please continue giving your feedback to ensure we do all we can to help you, your family and your community. Working together, we can get Iowa back on the right track.

  • Democratic Senators announce Medicaid Improvement Bill

    DES MOINES —  Two health care leaders in the Iowa Senate have introduced legislation to make significant reforms to Iowa’s privatized Medicaid system.

    Senate File 156, the Senate Democratic Medicaid Improvement Bill, has been introduced by Senators Amanda Ragan of Mason City and Liz Mathis of Hiawatha.  They are, respectively, the ranking members of the Senate Health & Human Services Budget Committee and the Senate Human Resources Committee.

    “Governor Reynolds and legislative Republicans are sticking with privatized Medicaid,” Ragan said.  “Given that, our focus is making urgently needed improvements.  We are proposing large and small improvements to how privatized Medicaid serves Iowa families and healthcare providers.”

    “Iowans need privatized Medicaid to do three things and do them well,” Mathis said. “One, make sure Iowans get the healthcare services they need when they need them. Two, make sure Iowa healthcare providers are correctly paid for the work they do and paid on time. Three, key Medicaid decisions should be made by Iowans rather than by employees of out-of-state, for-profit companies.”

    News Conference Video:

    Senate File 156 Highlights

    Senate File 156 would make these  changes to Iowa’s privatized Medicaid on behalf of Iowa patients and providers:

    Return the Long Term Services and Supports (LTSS) population to publicly managed Medicaid

    The MCOs are supposed to make money by helping sick people get better and thereby lowering costs. Many Iowans suffering the most from privatized Medicaid system are Iowans living with severe, complex, permanent disabilities and conditions.  Because these Iowans aren’t going to “get better,” denying care and cutting needed services is largely the only way to “save money.”  This is unacceptable.

     

    Require independent conflict-free case management and assessments

    There is an inherent conflict of interest in privatized managed care.  Case management and patient assessments are both performed by employees of the MCO that pays for the care of those patients.  Assessments are more accurate when made by an independent entity and coordinated by case managers who  put the patient’s best interest first.

    End the practice of requiring prior authorization for substance abuse treatment

    Every substance abuse counselor knows that an immediate response is essential when someone requests treatment.  “Medication assisted treatment” can quickly take away the cravings once it begins.  However, waiting for prior authorizations results in missed opportunities or even overdose deaths that could have been prevented.

    Require MCOs to develop and implement workforce recruitment, retention and training programs

    Iowa has a severe health care workforce shortage.  The MCOs now manage the care of some 600,000 Iowans.  Every other major health care provider and insurer in the state of Iowa contributes time, talent, and money to efforts to expand and improve Iowa’s health care workforce.  This legislation will require the MCOs to join that effort.

    Implement an external review process for providers

    Today, when the MCOs deny a claim, an Iowa health care provider can only attempt  to negotiate with MCO that denied the claim. When commercial health insurers deny claims, providers can appeal to an external reviewer.  This legislation establishes a similar appeal system when the MCOs refuse to pay for care.

    Make it easier and quicker for members to switch MCOs

    If a local doctor decides to switch the MCO he or she contracts with, that doctor’s patients must be able switch COs if they want to continue seeing that doctor.  Currently, patients must wait up to 45 days before they can ask DHS to approve a change for good cause.  This is an unusually long and burdensome process for Iowans.   This legislation would allow patients to request that DHS approve an MCO switch after 10 days.

    Move the Managed Care Ombudsman Program to the State Ombudsman’s Office

    Independent advocates for Iowans are an absolute necessary if Iowa managed care is going to work.  Iowa’s Long Term Care Ombudsman has only one full-time managed care ombudsman.  There could be three to four more working for Iowa families and health care providers if we took full advantage of federal matching funds.  The MCO ombudsman services should be moved to the State Ombudsman Office.

    -end-

  • Jochum receives Pharmacy Association’s “Good Governance Award”

    During the Iowa Pharmacy Association’s annual Legislative Day, State Sen. Pam Jochum accepted the organization’s annual Good Governance Award for her efforts and support of public health and the pharmacy profession. More than 200 pharmacists, pharmacy technicians and student pharmacists were on hand, including (from left) Grant Houselog, Steven Lenda, Andrew Sabers, Verent Yee and Steven Strong.

    IOWA SENATE NEWS
    January 29, 2019

    State Sen. Pam Jochum (D-Dubuque) was presented today with the Iowa Pharmacy Association’s Good Governance Award during the organization’s annual Legislative Day in Des Moines.

    The Good Governance Award recognizes Sen. Jochum’s legislative efforts and support for public health and the pharmacy profession.

    “Keeping the health of Iowans front and center has always been a priority for me. This year, I continue that focus through my service on the Human Resources and State Government committees,” Sen. Jochum said. “It’s an honor and a privilege to fight for good health care and the work of our health care providers.”

    Sen. Jochum is a state leader on health care issues. She has worked to expand affordable health insurance coverage to thousands of working Iowans, to protect the health services of Iowans with disabilities and to ensure all Iowans have access the health care they need.

    “Sen. Jochum understands the importance of protecting patients and has worked tirelessly to ensure healthcare providers are equipped to provide the best care possible. She has been a constant source of advice to the pharmacy profession and has positively influenced our legislative priorities over the past 25-plus years,” said Kate Gainer, executive vice president and CEO for the Iowa Pharmacy Association.

    Sen. Jochum is an Assistant Democratic Leader. She serves on the following committees:

    -end-

  • Senate Dem Leader on abortion ruling

    Jan. 22, 2019

     

    Statement from Senate Democratic Leader Janet Petersen on Court Decision

    “The District Court decision sends a strong message to Iowa women that their constitutional rights are important and their health care decisions should be made by them, not politicians.

    “The extreme law should have been overturned because it restricted the freedom of Iowa women and girls to care for their bodies and it forced  motherhood on them.

    “The Governor and legislative Republicans should stop attacking women’s health care. I want Iowa to be known as the safest place in the country to have a baby.”

    -end-

  • Partial review of privatized Medicaid disaster doesn’t answer concerns

    Iowa Senate News Release
    For Immediate Release:  November 26, 2018

     

    Statement from Senator Pam Jochum on partial review of Medicaid privatization disaster

    “The partial review of the Medicaid privatization disaster by the departing State Auditor is a big pile of excuses with no good answers for Iowa taxpayers who are being ripped off.

    “State Auditor Mary Mosiman joins a long line of Republican politicians – led by Governor Reynolds and Republican legislative leaders – who still cannot answer these simple questions:

    • What data is there to show that privatized Medicaid is making Iowans healthier?
    • What data is there to show how much the out-of-state corporations still owe Iowa hospitals, doctors and other health care providers for services provided to Medicaid members?

    “We remain concerned that the unexpected $100 million increase in payments to the out-of-state corporations running Medicaid will result in further cuts and delayed payments to Iowa health care providers that provide critical services to hundreds of thousands of Iowans, as well as additional cuts to education, health care and public safety to cover the additional payments to the corporations.

    “We hope that the Governor and legislative leaders of both parties will work with the newly elected State Auditor, Rob Sand, to open up the books and give Iowans an honest assessment of the impact of privatized Medicaid on Iowa taxpayers, Medicaid members and health care providers.

    “Finally, we renew our call for Governor Reynolds and legislative Republicans to finally reverse course and join legislative Democrats in supporting a return to a more efficient, publicly managed system.”

    -end-

  • Is rationing health care the Iowa GOP’s secret plan to “fix” Medicaid mess?

    IA SEN NEWS
    Oct. 30, 2018

    In the final days of the 2018 campaign, a Northwest Iowa State Senator may have mistakenly released the Republican Party of Iowa’s secret plan to “fix” the Medicaid privatization mess.

    During a forum last week sponsored by the Sioux City Rotary Club, State Senator Jim Carlin of Sioux City proposed rationing health care for Medicaid recipients.

    Carlin specifically said lawmakers should “look into limiting the number of doctor visits” by people on Medicaid.

    Senate Democratic Leader Janet Petersen called Carlin’s proposal “mean-spirited and dangerous.”

    “This is another example of a politician playing doctor,” Petersen said. “The last thing that Iowa parents need is to be worried about politicians placing arbitrary caps on the number of times their children can visit the family doctor for an ear infection, a broken arm or diabetes. And how could the Legislature and Governor limit the number of doctor visits for disabled Iowans or those with chronic illnesses? That’s mean-spirited and dangerous.”

    Throughout 2017 and 2018, Governor Reynolds and other Republican leaders acknowledged “mistakes were made” with Medicaid privatization, but they have offered no solutions for reversing course on a change that has turned over health care management for hundreds of thousands of Iowans to out-of-state corporations.

    As a result, the Reynolds Administration, Senator Carlin and others in the Republican-controlled Legislature have led an effort that has:

    1. Cut and delayed payments to Iowa health care providers that provide critical services to hundreds of thousands of Iowans.
    2. Made health care services even less accessible to Medicaid members.
    3. Shifted more than $100 million away from education, health care and public safety to cover the additional payments to out-of-state corporations.

    “Make no mistake about it, Senator Carlin’s plan would cost Iowa taxpayers more money in the long run and would further endanger the health and safety of Iowans,” Petersen said.

    Read the full Sioux City Journal article: https://tinyurl.com/yd4oouq2

    – end –