Iowa lawmakers approve $2 billion budget for health, human services

DES MOINES — A health and human services budget that Democrats called the best they could recall in several years, was approved largely without their support, 54-35, by the Iowa House on Monday.

The Senate followed suit in the evening, approving the spending bill on a 43-1 vote. It now heads to Gov. Kim Reynolds for her consideration.

There were parts of the massive budget Democrats liked — and that some had voted for previously.

“As with all bills, there are things that are good, and there are things you may not think are good or you could do a better job on,” Rep. John Forbes, D-Urbandale, said about House File 891.

“My caucus has tried to take a bill and make it better. A lot of amendments we asked for do cost money, and we think we have the ability to fund these priorities if we wanted. Unfortunately, the majority party did not agree.”

Health and Human Services Chairman Joel Fry, R-Osceola, liked many of the Democrats’ proposals but said they should be rejected either because of the cost or because the cost was unknown.

His rough math showed the Democratic amendments would have added at least $76 million to the $2 billion-plus budget that funds the Departments of Aging, Human Services, Public Health and Veterans Affairs.

“It would be very irresponsible to increase the budget in that way without understanding where that money would come from or how we would pay for it in future years,” Fry warned.

The ranking Democrat on the House Appropriations Committee, Rep. Chris Hall, D-Sioux City, pointed out the March Revenue Estimating Conference projected Iowa will increase revenues by more than $300 million in each of the next two years. The federal government will pick up an additional $450 million in Medicaid costs over the coming years.

That’s $1.2 billion in new revenue or dollars made flexible by federal assistance, Hall said.

Some of that money — $15 million — would be well spent to provide funding for children’s mental health services, said Rep. Timi Brown-Powers, D-Waterloo.

“It’s time for this state to actually put our teeth, or better yet, some money, in the policy we all worked very hard to pass for child mental health,” she said.

The Legislature approved the framework for a children’s mental health system but has not funded it, she said. County supervisors say they don’t have adequate funding and if they add children’s services, they may have to cut adult services.

Although Gov. Kim Reynolds and Senate Republicans are proposing a sweeping tax bill that includes the state takeover of mental health funding, Brown-Powers was skeptical it would improve or expand those services without additional funding.

Another amendment would have increased the 4.5-gram limitation on medical marijuana to 15 grams per 90 days.

That’s “sub-therapeutic,” according to Forbes, a pharmacist. People in the state’s medical marijuana program tell him they return to opioid medication to treat symptoms such as chronic pain

Increasing the limit from about 50 milligrams per day to 165 milligrams likely would meet the needs of about 90 percent of the people enrolled in the state program, he said.

In both cases, their amendments were ruled non-germane to the budget bill.

Democrats also offered amendments to:

In the end, House Democrats Forbes, Brown-Powers and Dave Williams of Cedar Falls, voted for HF 891. Two Republicans, Reps. Jon Jacobsen of Council Bluffs and Mark Cisneros of Muscatine, joined Democrats in voting against it.

In the Senate, multiple Democrats expressed their support for the bill, but said they had hoped for pandemic relief funding or money for the state’s new mental health care system for children, neither of which is in the bill.

Comments: (319) 398-8375; james.lynch@thegazette.com

Erin Murphy of the Gazette-Lee Des Moines Bureau contributed.