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Senator Ragan works for more oversight of Medicaid

Ragan speaking on the bill
State Senator Amanda Ragan of Mason City speaks on the floor of the Iowa Senate during debate on House File 2460, the Health and Human Services Budget. The Senate amended the bill to include strong oversight protections for privatized Medicaid. The amended legislation now heads back to the Iowa House.

Remarks on HF 2460, the Health and Human Services Budget by Senator Amanda Ragan of Mason City, Chair of the Health and Human Services Appropriations Subcommittee:

Thank you Madam President

This year’s general fund target for Health and Human Services, agreed to by the Iowa House and Senate, is just $4 million over last year’s budget.

That’s an increase of only 0.2%, amazing frugalness for the need we face.

Given that fiscal reality, the committee did our best to protect children, seniors, people with disabilities, and every Iowan’s access to essential services.

Those “essential services” are necessary services that keep people alive and relatively healthy.

While the legislation before you is a strike after amendment, it reflects significant bipartisan agreement with the House.

For example, the House and Senate BOTH support investment in “First Five,” the children’s mental health initiative in this legislation. Encouraging the mental health of children ages 0 to 5 is a smart, cost-effective investment in Iowa’s future.

The House and Senate BOTH support the push for better healthcare workforce strategic planning in this legislation. Successful health care, more than any other industry, demands qualified, skilled, caring people. Iowa needs to improve in this area.

The House and Senate BOTH support rate protections in this legislation for key providers as we continue the transition to managed care.

The House and Senate BOTH support the push in this legislation to reduce waiting lists for Home and Community Based Services.

The House and Senate BOTH support the investment in this legislation to improve state-wide mental health services for our citizens who need them.

The most important and significant area where the Iowa House and Senate DISAGREE is Medicaid oversight, protecting the safety net our Iowa families depend upon for quality medical care.

There are three key differences between the House and Senate legislation:

One, the Senate legislation requires specific improvements in consumer protections, children’s health care, provider participation, rates and payments, and evaluation and oversight.

The House language falls far short of what is needed to protect more than a half a million citizens who depend on Medicaid for their health care services.

Two, the Senate legislation funds three additional ombudsmen for managed care. This is the minimum the Senate believes is necessary to help caregivers, patients, and family members navigate this significantly more complex and unfamiliar system.

Three, the Senate legislation requires, at a minimum, quarterly meetings of the joint Health Policy Oversight Committee. The House does not. We believe there have to be monitors of the bureaucratic administrators.

The Senate’s requirement of strong Medicaid oversight—strong protections for our health care safety net—is by far the most significant difference between the House and Senate versions of the HHS budget.

I ask for your “yes” vote today on House File 2460, the Health and Human Services Budget.

Vote “Yes” for compassionate provider services.

Vote “Yes” for peace of mind for hard working family members struggling to support their loved ones who rely on Medicaid.

Vote “Yes” to insure that the privatization of Iowa’s Medicaid program truly does benefit the sick and the encumbered, not simply the private insurers.

Every “yes” vote in the Senate will increase the chance that Iowans will get what they have repeatedly, urgently asked for and desperately need: strong, effective Medicaid oversight to protect the health care safety net for disabled and elderly Iowans who strive to overcome their disability and disease.

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