|
AEAs, Postpartum Coverage, Religious Freedom & More
While the Iowa Senate took on such big issues as fake meat product labeling, employment of unauthorized aliens, allowing guns as bingo prizes, and banning the use of bots to buy concert or game tickets, the House conducted more weighty debates such as AEA reform, further gutting university DEI efforts, and religious freedom.
Some of the Governor's priorities are moving quickly through the process, while others are stalling. There has been no movement on the Governor's boards & commissions review committee recommendations. The House version takes out all controversial professional licensing board mergers while still removing 40+ boards. The Senate version is more closely aligned with the Governor's recommendations, with a few tweaks to address concerns of electricians and massage therapists. Since both bills deal with the same subject and are on their respective calendars, they are considered "funnel-proof."
One part of the boards & commissions review passed the Legislature last week. Senate File 2096 , which ends the requirement for gender balanced local and state boards and commissions, is on its way to the Governor. The bill passed on near party line votes; 62-33 in the House and 32-15 in the Senate. Sen. Herman Quirmbach (D-Ames) was the only Democrat to vote for the bill.
The Governor's newest attack on transgender Iowans came in the form of HF 2389, which defines "man" and "woman" along stick binary lines based on gender assigned at birth. It also requires that any changes in birth certificate later reflect both the sex at both and gender reassignment. The bill has not yet been scheduled for debate, and the longer the delay, the more likely it will die before the funnel deadline.
The Governor's bill to expand access to contraceptives is also facing a floor attack from the conservative right. HF 2584, which allows a pharmacist to order and dispense hormonal contraceptives, has been loaded up with extreme amendments that would require a patient to watch the medically inaccurate "Baby Olivia" video, allow access only to patients assigned female at birth, require patients be provided information directing them to the nearest ER in case of a medical emergency resulting from use of hormonal contraceptives, protecting pharmacists who refuse to do this from civil liability, requiring information be provided about the psychological and physical consequences of surgical and chemical abortion, requiring the pharmacist inquire whether a person accompanying a woman is a pimp, providing alternatives to abortion, and requiring pimps pay a $10 registration fee to access contraceptives. The bill is likely permanently stalled. If it is going to move, it will have to do so as a part of a bigger bill.
Speaking of the "Baby Olivia" video, a bill passed on a party-line vote in the House will require all schools show the video in Human Growth and Development classes.
The Governor's proposal to expand postpartum Medicaid coverage from 60 days to 12 months passed the Senate and is ready for a House vote. While the bill expands coverage, it also limits eligibility to those earning up to 215% of the federal poverty level. The reduction means 1,300 women and 400 infants will lose access to this expanded Medicaid benefit. Since it applies across the board to pregnant women as well as infants, women between 215-375% poverty will have no where else to go to receive affordable health insurance (since pregnancy is not a qualifying event for ACA exchange plans). IPA is a member of a coalition that continues to work with legislative leaders to find ways to expand this eligibility, but we have been told the bill will pass as is. There are still opportunities to adjust eligibility in the budget bills, but it's not looking good right now.
Perhaps the Governor's proposal that has received the broadest of attacks is her plan for a state takeover of the Area Education Agency (AEA) system. Parents, teachers, school board members, AEA staff, and many health professions immediately spoke out against the bill. Legislators said they received no letters of support but thousands opposed.
On Thursday, the Iowa House of Representatives passed their scaled back, slowed down version (HF 2612), which passed 53-41. After the bill was amended and passed, the association representing AEAs moved their position from opposed to neutral.
Rep. Skyler Wheeler (R-Sioux Center), who led the bill during debate and is himself a parent of an autistic child, said “We have listened to the feedback in this process…We have listened to everybody in the state. We have done our due diligence. And that’s why the bill before us today is phenomenal.”
As amended, the bill slows down the timeline, expands the task force looking at future changes, and creates a smaller state oversight structure. During debate, Rep. Wheeler read an email he had received from former DE Director Brad Buck, who is now the superintendent at Waukee. Buck had been a vocal opponent of the Governor’s changes, but has now said there is much to be appreciated in the bill:
- Special education remains a core service of the AEAs.
- Complete funding of special education and instructional services.
- A reasonable timeline for the transition of media and instructional services to pay for service model.
- The creation of a task force to deeply consider what is needed going forward.
- Significantly limiting the purview of the Department of Education.
The House also has not scheduled the Iowa Health Information Network bill (HF 2623) for debate yet. Most health professional groups oppose the bill because it requires all providers with electronic health records to pay the fees set by the organization running this and participate in it. This includes hospitals, clinics, mental health professionals, pharmacists, dentists, and more. It's highly unlikely this bill will make it through, particularly without an amendment to go out for an RFP (the company running it right now is SyncHealth).
The House also passed the Religious Freedom Restoration Act (SF 2095) on Thursday, sending it to the Governor for a guaranteed signature. RFRA sets a higher legal standard to be used in cases where a person feels government has interfered with their ability to freely practice a religion. Rep. Lindsay James (D-Dubuque), a college chaplain, said RFRA "weaponizes religious beliefs in order to justify discrimination." She went on to say that these laws are "allowing the religious beliefs of one to violate the civil liberties of another." Rep. Megan Srinivas (D-Des Moines), who is a doctor in real life, talked about instances where people were denied HIV medication because a pharmacist did not agree with the person's lifestyle. Expect this bill to be signed into law soon.
The House unanimously passed HF 2573 last week, requiring provider-patient consultations done via telehealth for the purposes of getting a medical cannabidiol card to comply with the Board of Medicine’s rules on telemedicine. One of the rules requires an Iowa license; another requires scope of practice be in line with the services provided via telehealth.
HF 2488 received unanimous House approval; it sets prior authorization standards for commercial insurance. Responses to urgent requests must be completed within 48 hours, while insurers have up to 10 calendar days to respond to non-urgent requests. There is an exception for complex or unique circumstances, or for times when there is an unusually high level of requests (allows up to 15 calendar days). Insurers must acknowledge receipt of the request within 24 hours. Insurers are also required to annually review prior authorization determinations and eliminate prior authorization for those that are “routinely” approved. The Insurance Commissioner is charged with fielding complaints. The bill also requires insurers to establish a prior authorization exemption program by January 15, 2025. This would exempt a subset of providers, including some primary care providers, from prior authorization requirements.
Two compacts passed the House unanimously last week - the Social Worker Compact & the Dietician Compact (both are in Senate State Government). The House also passed HF 2486 last week to allow a licensed professional to carry over up to 50% of the required renewal period CEUs.
People who assault health care workers will face tougher penalties under a bill passed by the House and ready now for Senate debate (and safe from the funnel). Spitting on health care workers would also be considered an assault under the bill. Ambulances will be able to drop off patients experiencing a mental health crisis at Access Centers under HF 2397, which passed the House.
The Senate sent its approach to opioid settlement spending (SF 2395), giving the Attorney General free rein to spend 25% of the funds and HHS to spend the other 75%. The House and Governor have bills that would outline spending, and it looks like the decision on this will be tied up in budget negotiations.
It would not be an Iowa legislative session without gun legislation. The House passed three bills this week to address various issues with guns. HF 2464, which passed the House (68-27) and is already out of a Senate subcommittee, prohibits a governmental body to keep a record of privately owned guns (except for criminal investigations). It also bans the use of special codes assigned by banks and credit card companies to gun sellers and does not allow them to decline payments due to a purchase of a firearm. On the other hand, HF 2421 is supported by some gun safety advocates; it gives companies that voluntarily hold a person's firearms immunity from civil liability. It passed the House with bipartisan support (89-2).
Of course the answer to school gun violence is more guns (sarcasm intended), so the House passed (61-31) its school security bill (HF 2586). The bill requires school districts >8,000 students employ either a school resource officer or a private security firm to guard grade 9-12 schools, but now allows the majority of the school board to vote against taking such an action. Smaller schools are encouraged to employ security. Not to bury the lead, but school employees are allowed now to carry weapons on school grounds if they have proper training. The bill is now in the Senate Education Committee.
Check the IPA Bill Tracker for updates and other bills not listed here.
| 
