Medicaid Expansion Train Headed Down the Tracks
This week in the Iowa Senate, Democrats passed a bill expanding the Medicaid program. The passage of SF 296 sends the Medicaid Expansion train out of the station and down the tracks with little consideration of the passengers' well-being or the long-term journey. Chronic disease and obesity are growing problems, and not enabling recipients to take ownership of their health care coverage does them a disservice and only makes the problem worse.
Participation in the broken Medicaid program has nearly doubled over the last decade. Iowa currently has almost 500,000 Medicaid enrollees. If the program is expanded, it is estimated the Medicaid population will grow by an additional 110,000 to 181,000 recipients who have no personal responsibility for their health and no accountability for the health care provided.
The passage of this bill simply throws money into a broken system that neither requires Iowans to take personal responsibility for their health nor provides for outcome-based solutions. Iowans deserve affordable healthcare and allowing our state to become beholden to the federal government by expanding a flawed system is not the answer. Working to identify solutions to help Iowans lead healthier lives will reduce healthcare costs without saddling Iowans with higher taxes to pay for an unsustainable program.
Many of us believe we should allow more time and consideration to examine the governor's Healthy Iowa Plan proposal prior to making a decision on the expansion of Medicaid. It may not be the answer we're looking for either, but we owe it to our citizens to look at all possible options before signing up for a Medicaid expansion that we will never be able to retract. It remains to be seen what the House will do with SF296.
Education Reform - Evolution or Revolution?
The Wednesday Senate debate calendar included a lengthy discussion about education reform. A few weeks earlier the House had passed their version of the education package which included some good changes, and some that were questionable in my mind. The House also included 2 percent Supplemental State Aid (formerly Allowable Growth) in their education bill. However the Senate version that passed Wednesday on a strictly party line vote was focused on the status quo, with 4 percent Supplemental State Aid.
The title of the bill suggested significant, sweeping changes for education in Iowa: An Act relating to and providing for education reform involving student, teacher, and administrator programs and activities under the purview of the department of education, the state board of education, college student aid commission, school districts and accredited nonpublic schools.
In reality, the majority party was content to nibble around the edges of true reform, with the constant refrain that more money is the key to improving education performance. Senate Republicans offered more than a dozen significant amendments that were consistent with the title of the bill, and would offer true reform, only to have nearly all the amendments ruled "non-germane."
The two amendments that were allowed to come to a vote were defeated on a party line vote. The message is clear that the minority party has nothing to contribute to the debate, and that the majority party has all the answers. The irony is that Senate Republicans were lectured earlier in the week about "reaching across the aisle" to pass legislation in a bipartisan way.
So now we're left with three versions of education reform. The House Republican plan, the Senate Democrat plan and Gov. Branstad's plan. We'll have to see what comes out of conference committee, but there is still a lot of work to do.