Bills on the Move

The Senate has wrapped up its review of the bill that reorganizes state government (SSB 1123). It will come out of committee this week.

The House has one more subcommittee meeting on its bill (HSB 126) but also plans to get it out of committee this week. There will be an amendment at some point in the process, but we do not yet know if the concerns advocates from the disability communities (including individuals who are deaf/hard-of-hearing or blind/sight-impaired will be included in the fix.

Here are a few updates on bills we've been watching:

• The House passed (95-0) HF 252, which provides up to $5,000 scholarships to young adults with intellectual and learning disabilities to attend college-based transition programs like the University of Iowa's REACH and Northwestern College's NEXT programs. The bill was changed so that the money the state puts into the program can be matched by federal vocational rehabilitation funds. That's $3 in federal funds for every $1 state dollar!

• The House also passed (99-0) HF 243, which ends insurance limits on autism treatment.

• The bills (SF 343, HF 285) that require schools to excuse a student leaving school for autism treatment may make the funnel. A House subcommittee already moved its bill on, and a Senate subcommittee meets today (Monday).

• A Senate subcommittee approved a bill that requires school staff to be trained on seizure identification and seizure first aid (SF 177). It will need to make it onto the Senate Education Committee agenda this week to stay alive.

• Three voting bills moved out of a Senate subcommittee late last week, despite opposition from voting rights groups. The bills allow anyone to challenge the registration of a voter (SF 351), require the state to keep records of who people voted for (SF 341), and require that every early in-person voter cast a provisional ballot that may or may not be counted (SF 342). It sounds like the Senate State Government Committee may vote these bills out this week

HHS Questions Adult Dental Benefit Package

The Iowa Department of Health and Human Services (HHS) presented its "Improving Medicaid Program for Members" report last week during a House-only Health & Human Services Budget Subcommittee meeting. A large part of the review outlined how the state needs to develop a better, more cohesive, more transparent home and community based services system (as an alternative to higher-cost facility-based institutional options). The report did also highlight Medicaid rate structures and found: 

• Need to set a regular, fact-based review process for rates.
• Physician and behavioral health rates are most in need of increase.
• You can see the comparison of rates here.

HHS also highlighted concerns with the state's dental program, saying dental contracts are not being as efficient as other state programs. The following concerns were brought up:

• Lack of choices.
• Instability of dental contracts and coverage.
• Lack of innovation.
• Outdated contract terms.
• Lack of competition. 
• Misaligned with Iowa Medicaid's vision for integrated care.

To address these concerns, HHS is in the process of putting out a contract for dental care services, with the goal to have them onboard next Summer (2024). A dental stakeholder work group has been looking at options, which include:

• Reducing the adult dental services available to align with other states, and using savings to increase rates for preventive care. Iowa is in the group of 19 states that have "extensive coverage" for dental services.

• Changing methods of authorizing and reimbursing for orthodontia.

• Increasing ability of dental hygienist, dental assistants, and dental therapists to fill access needs (allow dental hygienists to bill directly, adding dental therapy).

HHS also announced it would be maximizing state Medicaid dollars by adding a new process that allows the state's insurance tax on MCOs to be used to draw down additional federal dollars (basically adding more money into the Medicaid system without adding any more state dollars). That bill (HSB 177, SSB 1167) passed out of the House HHS Committee and is scheduled to come out of the Senate HHS Committee this week.