Iowa House set to debate smaller health, human services budget

DES MOINES - Setting the stage for a conference committee settlement, the Iowa House Appropriations Committee approved a health and human services budget that calls for spending about $61 million less than the $1.9 billion fiscal 2016 budget the Senate approved last week.

On Tuesday the House Appropriations Committee, on a party-line vote, amended Senate File 505 to reduce spending to $1.845 billion.

The biggest difference between the Senate budget and the one the full House is expected to debate Wednesday, according to floor manager Rep. Dave Heaton, R-Mount Pleasant, is that Senate Democrats doubled the projected savings from the proposed transformation of Iowa's $4.2 billion Medicaid program into a managed care system that will enlist private health care vendors to coordinate care and manage program spending.

The Department of Human Services projected $51 million in savings, 'but the Senate doubled that and spent the extra $51 million on things in the budget,” Heaton said. 'That's actuarially unsound.”

Heaton's budget includes $1.8 million and $1.04 million to keep the mental health institutes at Clarinda and Mount Pleasant, respectively, open through Dec. 15. Gov. Terry Branstad did not budget any funding for them, but Heaton hopes to find private providers to operate the facilities after Jan. 1.

What if the state doesn't find a private provider to take over the MHIs, Rep. Todd Taylor, D-Cedar Rapids, asked Heaton.

'I'm trying to keep the lights on and not turn them off,” Heaton said. 'I can't do that with your legislation.”

'There are 17 reasons to note ‘no,' and this is the No. 1 reason,” Taylor responded.

It was not the only objection from the committee's Democrats. They disagreed with the overall decrease as well as a change in funding for family planning services. The GOP budget maintains the same funding level, but that would ban state-controlled funds from going to agencies that either perform abortions or maintain facilities where abortions are performed.

He expects that to be one point of contention when the bill is debated Wednesday.

'The body knows this is going to a (House-Senate) conference committee,” Heaton said. 'However, if the minority party wants to express disappointment or bring up things to add to the budget, well, that's the process.”

The budget is less than ideal, he said, 'but we were dealt a budget target that was low because of what we are doing for education and because revenues were about 2 percent less than expected.”

Also, Heaton said, Medicaid expenditures continue to grow about 11 percent a year.