Iowa Senate Democrats

Fighting for a Better Deal for Iowans.

  • Nursing students aim to fill health care needs

    By Senate Intern Kylie Spies, University of Iowa MSW student

    Richie Gibbs, Erica Altemeier and Madelynn Rhodes are nursing students at Des Moines Area Community College.

    Students from DMACC’s RN training program were on hand for Career and Technical Education Day at the Capitol. They shared with legislators how their program is helping prepare Iowans for high-demand jobs.

    Iowa is experiencing shortages in OB-GYNs, mental health providers, nurses and other health professions. In 2018, U.S. News ranked Iowa 36th in the nation in overall health care, and 46th in hospital quality.

    State-of-the-art training can help turn things around. The Healthcare Simulation Lab, located on DMACC’s Capitol Center campus, offers high-tech learning opportunities for future nurses and other health care professionals.

    While at the State Capitol, nursing students demonstrated surgical technology, hospital newborn care equipment and a child-sized dummy with a pulse. They take pride in the skills they’re gaining, but are well aware of the challenges facing Iowa’s health care system.

    Take Medicaid, for example.

    Richie Gibbs, Erica Altemeier and Madelynn Rhodes are all in the last semester of their Registered Nurse program. Even before entering the field, the three have witnessed how privatized Medicaid is squeezing providers.

    “We are close to the bottom in pay here in Iowa,” Gibbs said.

    As of 2017, the U.S. Bureau of Labor Statistics ranked Iowa 48th in the nation in average nursing salary—$57,930, or $27.85 per hour. That includes many nurses with decades of experience.

    In addition to the usual college courses, nursing students must take clinicals. Clinicals involve shadowing a practicing nurse to get hands-on experience in the field. DMACC nursing students have seen overworked, underpaid hospital staff that cannot keep up with the demand for care.

    For many nursing students, the first career step is as a Patient Care Technician. PCTs are entry-level health care workers who do hard physical labor, like feeding, dressing and bathing patients. Most make only about $13 per hour.

    Rhodes, who works as a PCT in a facility for seniors with dementia, says patients pay more than $100,000 per year at the facility, and that her pay is higher than many of her classmates.

    Altemeier received a grant from Central Iowa HealthWorks to help pay for tuition, books and gas to get to her classes and clinicals. Iowa HealthWorks is a United Way program that helps adult learners reach their health care career goals. Altemeier is grateful for the assistance, and says she wishes more money was available to help Iowans get into the profession. Some of her classmates come from other states to take advantage of DMACC’s program, but always intend to return home where they’ll make more money.

    Altemeier wants to see the state invest in people who are interested in becoming nurses or Patient Care Technicians, as well as competitive salaries that will keep talented nurses here in Iowa.

    Iowa cannot provide adequate health care services to those most in need without a bigger investment. Let’s not continue this race to the bottom.

  • Urge Gov Reynolds to let parents affected by individual health insurance crisis to buy hawk-i children’s health insurance

    Iowa Pediatrician Amy Shriver, MD, and State Senator Janet Peterson support allowing parents unable to buy insurance on the individual market to buy into hawk-i, Iowa’s children’s health insurance plan..

    July 24, 2017  (Des Moines)  Today at the Iowa Statehouse, a state senator and an Iowa pediatrician proposed a plan to protect more than 11,000 Iowa children from losing health insurance on January 1 of next year.   The children’s parents are among those who would lose all access to health insurance if the individual market in Iowa collapses or the policies in the individual market are not affordable.

    “There is a very real possibility that 72,000 Iowans could be without health insurance next year.  Governor Reynolds should immediately ask the Trump Administration to allow Iowa families to purchase health insurance for their children through hawk-i, Iowa’s children’s health insurance program,” said State Senator Janet Petersen of Des Moines.  “This is a simple, affordable and straightforward solution that would give thousands of Iowa families the certainty that health care will at least be there for their children.”

    Hawk-i provides health and dental insurance to children aged 18 and under from lower income families.  Parents pay premiums on a sliding scale and the rest of the costs are picked up by the state and federal government.  The program was established with strong bipartisan support in 1999.  Iowa’s program has earned widespread praise for providing high quality care, being easy to use, and having low administrative costs.

    Under the proposal, Iowa families unable to purchase health insurance elsewhere could buy insurance for their children through hawk-i.  Parents would pay the full cost of the premiums, which are expected to be affordable due to the relatively low cost of insuring children.

    “We already collect premiums based on a family’s ability to pay,” said Petersen. “We aren’t asking for additional federal or state dollars to make this plan happen.  All we need is the federal government’s permission to allow Iowa parents to buy into hawk-i.”

    Dr. Amy Shriver, a Des Moines pediatrician, said: “Access to healthcare, including oral care, is essential to children’s healthy development and future success.  Children learn best when they are healthy and safe. Children need regular, preventive well-child checkups.”

    Petersen’s experience with these issues includes her past service on the hawk-i Board of Directors and years of experience working with insurance issues as a leading member of the Iowa Senate’s Commerce Committee.

    “Iowa families on the individual market are small business owners, self-employed, or work for organizations that don’t offer group plans. They are just a few short months away from losing their health insurance and are without affordable alternatives.  With no sign of a viable solution coming from Congress, we need Governor Reynolds to act,” said Petersen.  “Governor Reynolds, please ease these parents’ fears.  Use your power to push for a solution Iowans can actually afford – especially for our kids.”


    Summary: Keeping Iowa’s Kids Insured

    Background:

    • Iowa has consistently ranked in the top states in the country for children’s access to health care and dental care.
    • Iowa’s Children’s Health Insurance Program provides coverage to over 60,000 children.
    • The covered services under hawk-i are approximately equivalent to the benefit package of the state’s largest HMO at the time the program was initiated.
    • Providing medical care through health insurance that includes essential health benefits is less costly, produces better results, and helps prevent unnecessary, costly visits to emergency rooms.

    The threat to health care coverage for more than 11,000 Iowa children:

    • It is possible that Iowa will have no insurance plans available in the 2018 individual market. Wellmark and Aetna have already dropped out.  Medica intends to stay in the marketplace and has requested a 43% rate increase.  There is no guarantee Medica will not back out later.
    • Iowa’s Insurance Commissioner has responded to the problems with the individual market by with a “Stop Gap Proposal” that is pending with CMS. The “Stop Gap Proposal” would use the federal funding that today provides ACA subsidies and cost sharing reductions to allow Iowans to purchase a public option plan, similar to a silver level ACA plan.  This plan will be available for purchase to all Iowans, some with a subsidy.  Families earning more than over 400% of the federal poverty level would not be eligible for a subsidy.
    • Both options under the “Stop Gap Proposal” will be very expensive. With Medica’s premiums going up 43%, many families will not be able to afford the plans, even if they get a subsidy.  can only buy into the program in January and must stay in all year to remain eligible.

    The Iowa Senate Democrats’ Expanded hawk-i Proposal: Making sure more than 11,000 kids have health care

    • More than 11,000 Iowa children receive their insurance coverage through an individual market plan purchased by their parents. They will not have access to health care if their parents cannot afford to buy a Medica or Stop Gap plan or the plans are not available.
    • In order to keep children insured, it is proposed to allow parents to buy into the hawk-i plan for their children ages 18 and below. It could also cover children up to age 26 as all private plans must currently do.
    • Expanded hawk-i would be available to families with incomes above 300% of the federal poverty level. (Those below 300% are already eligible for hawk-i.)

    Conclusion: Governor Reynolds should ask CMS for emergency approval to allow Iowa parents with incomes over 300% of the federal poverty level to purchase, without subsidy, hawk-i coverage for their children.  These families may be without any other options in Iowa in 2018.

  • Gov. Reynolds: Convince Pres. Trump to stop Iowa health care disaster

    June 21, 2017

    (Open letter from Senator Joe Bolkcom to Governor Kim Reynolds)

    Dear Governor Reynolds:

    Today, you will have an opportunity to speak one-on-one with President Trump in Cedar Rapids.

    I support your announced plan to raise the issue of Iowa’s failing individual insurance market.  However, that issue is only one part of Iowa’s health care problems.

    Governor Reynolds, you must be aware that the Republican-controlled U.S. Congress is rushing to send President Trump health care legislation.  This legislation will devastate Iowa families, Iowa health care providers, the State of Iowa’s budget, and the Iowa economy.

    That’s why Iowans are counting on you to convince President Trump to oppose this impending disaster.  Here are some of the reasons why the Republican health care bills are so bad for all Iowans:

    1. Proposed cuts to Medicaid expansion threaten health care for 150,000 Iowans.
    2. More Iowans will be living without health insurance. There will be more uninsured charity care, care that is less effective, more costly, and will increase everyone’s health care costs.
    3. Older Iowans, who make up an increasingly large share of Iowa’s population, will be hit especially hard by these changes.
    4. Cuts, caps or block granting federal Medicaid spending will cost the state of Iowa hundreds of millions of dollars.
    5. Health care providers will be paid less. It will be harder to recruit and keep qualified doctors, nurses and other caregivers, especially in Iowa’s small towns and rural communities.
    6. Health care is a large part of Iowa’s economy. Health care layoffs and wage cuts will hurt all sorts of Iowa businesses and weaken our economy.

    Iowa’s response must be bipartisan. That’s why at tomorrow’s meeting of the Legislative Council, I will propose that we create a special legislative interim committee to examine Iowa’s health care crisis and offer solutions.

    This committee would look at proposed Medicaid cuts, the collapse of the individual market, the repeal of the Affordable Care Act, and the impact on the state budget.

    Governor Reynolds, please use your influence with President Trump to make sure Iowans can keep their health insurance, to protect rural hospitals and health care providers, and to prevent a devastating blow to Iowa’s economy.

    I hope you will return to Des Moines with some good news.  We need some right now.

     

    Signed,

    Joe Bolkcom

    State Senator

    PDF of letter to Gov Reynolds