Iowa lawmakers propose $59 million increase for health and human services budget, totaling over $2 billion

DES MOINES — Iowa lawmakers are considering a $59 million increase in funding for health and human services for the coming fiscal year, once again pushing total state spending over the $2 billion mark for that budget.

The House Appropriations Committee on Wednesday approved a proposed fiscal 2022 health and human services budget of $2,047,793,079 for fiscal year 2022 beginning July 1.

Although Rep. John Forbes, D-Des Moines, called it the best health and human services budget he’s seen in eight years, most Democrats withheld support until they see what the budget looks like after negotiations with the Senate.

Not only are Democrats concerned that funding could be pared back, but they want to make sure that child care policy included by HHS Appropriations Chairman Joel Fry, R-Osceola remains in the spending plan.

“There are some good pieces of policy, some bipartisan pieces of policy that we have voted out of the House,” Rep. Chris Hall, D-Sioux City, the committee’s ranking Democratic, said about the budget.

“But I also sense that this is a moving target and that there are, at least within my caucus, concerns about the place that it will eventually land as the Senate negotiates some of those good policy pieces out.”

Fry said he “would never venture a guess for how the Senate will proceed. They’ve certainly missed the boat on a few of these (policy) pieces already.” However, including them in a bipartisan budget would “again send a signal on how important these are to all of us in the House.”

Among the highlights for Republicans and Democrats were increases in child care provider reimbursement and addressing the “cliff effect,” so working parents can accept raises or better-paying jobs without losing their child care assistance.

The proposal also would increase funds for mental health services for children and for home- and community-based services to help Iowans remain in their homes.

Another policy piece in the budget would require private insurers to reimburse providers for behavioral mental health services whether delivered in-person or via telehealth.

“The House has passed that bill twice and sent it to the Senate,” Fry said. “I believe Iowans across the state believe that telehealth parity is vital to mental health services in the state of Iowa.”

While the budget calls for a $59 million funding increase over the $1.99 billion expected to be spent on health and human services this year, it would be $19 million more than the $2.028 billion actual health and human services spending in the previous fiscal year.

A policy piece the House didn’t include, but which is in the Senate health and human services budget, is an asset verification that could limit the number of Iowans who qualify for food and Medicaid assistance.

House committee Democrats also raised a concern that a $1.14 million increase for the Department of Public Health would be inadequate.

“We’re in a health crisis, a pandemic,” Forbes said, noting that the department’s staff numbers have fallen over the years. “We don't know what's around the corner when it comes to all these different viruses.”

The health and human services budget, which typically signals the end of the legislative session is nearing, next goes to the full House. The Legislature is scheduled to adjourn Friday when lawmakers’ daily expense money runs out. However, leaders have indicated they expect the session will continue into May.

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