Iowa House approves $1.8 billion health, human services budget

DES MOINES - After taking an overnight break, the Iowa House finished work on a $1.8 billion health and human services budget Wednesday morning that minority Democrats argued doesn't reflect their priorities or those of Iowans and doesn't include adequate oversight of the transition to private Medicaid management.

Floor manager Rep. Dave Heaton, R-Mount Pleasant, conceded the 56-42 party-line vote reflected the divided sentiments of the House, but 'at the end, there will be people in this room who will be much happier.”

House passage is 'just the beginning” of completing the far-reaching health and human services budget, which, he said, is expected to be sorted out by a House-Senate conference committee.

Much of the angst with the budget was over the transition to private Medicaid management, which began April 1 despite warnings from Democratic lawmakers that Iowans who depend on the state-federal program would face cancellation of services, be forced to change health care providers and bureaucratic hurdles and delays.

In the big picture, Rep. Lisa Heddens, D-Ames, said the House plan underfunded Medicaid by $13 million - a practice not unusual regardless of which party controls the Legislature. That means that if cost-saving measure suggested by Gov. Terry Branstad don't yield the forecast $16 million, Medicaid will be underfunded by nearly $30 million.

It could have been worse, Heaton countered, if the state had not started the transition to private Medicaid management. 'Experts” told legislators to expect $110 million in savings in the first full year of private management.

'Even with those savings, we put an additional $41 million into Medicaid,” he said. 'Imagine the conversation this morning if we had to provide $151 million to continue the program as it was. Nothing, absolutely, nothing, would be available for anything else in this state's budget.”

In addition to concerns about the Medicaid transition, the lack of oversight and the lack of ombudsmen to help Medicaid beneficiaries through the changes, Democrats opposed a GOP provision to remove funding from providers, like Planned Parenthood, that perform abortions.

'In a tight budget year, we leave $3 million in federal money on the table for a program that 74 percent of Iowans want,” Rep. Beth Wessel-Kroeschell, D-Ames, said, referring to an Iowa Poll.

A similar measure last year was removed from the budget during conference committee negotiations with Senate majority Democrats.