February 14, 2016

‘Premium’ rate offered to Iowa doctors who treat Medicaid patients

A key Republican legislator says Iowa doctors who sign contracts with one of the three companies hired to manage care for Medicaid patients will be paid more than they would get in other states.

Representative Dave Heaton, a Republican from Mount Pleasant, is chairman of a budget panel that deals with this issue. Heaton says based on action in congress, many other states are reducing payments to doctors who provide care to low income and disabled patients who are on Medicaid.

“Iowa has elected as their base rate for primary care physicians to hold onto that enhanced rate and that is the base from which these docs are negotiating with these managed care companies…paying a premium above what other states are offering their doctors,” Heaton says. “Now, I want to go on and say this, that if these doctors don’t agree really with what is being offered them as a base, I think that they are putting my Medicaid population at risk.”

Nearly a year ago Governor Branstad unveiled plans to shift Medicaid patients into private managed care plans. About 560,000 Iowans get their health care coverage through the government’s Medicaid program.

“The greatest number of them will be affected from the outset on March 1, but the long-term care –people in the nursing home area of Medicaid, they’re still a year and a half away,” Heaton says.

State officials are still waiting for a federal agency to approve a waiver for Medicaid privatization to begin in Iowa on March 1. Heaton says he hopes that decision is announced next week to give everyone involved two weeks to get ready. Heaton made his comments today during taping of the “Iowa Press” program that airs tonight on Iowa Public Television.

House Republicans propose less spending than Branstad recommended

Pat Grassley

Pat Grassley

House Republicans are proposing a $7.32 billion state budget for next year.

“This budget has been put together in a mindful manner to make sure that we are living within our means, but also funding the priorities of Iowans,” says Representative Pat Grassley, a Republican from New Hartford who is chairman of the House Appropriations Committee.

Republican Governor Terry Branstad has drafted a slightly larger budget of more than $7.4 billion. Senate Democrats are proposing a spending level in between the targets set by Branstad and House Republicans.

State tax collections have not been as robust as previously predicted and Grassley says nearly all the new state tax revenue expected will be directed to K-12 public schools.

“Every budget should be very difficult as we’re spending the money of the taxpayers of Iowa,” Grassley says, “and I think we’ve done a good job of sticking to our commitments that we all made when we were all out campaigning and living within our means and that’s what this budget does.”

Grassley says House Republicans used the current year’s state budget as a starting point for their budget plan rather than using the budget documents Governor Branstad delivered to legislators on January 12.

Upmeyer says too many ‘unanswered questions’ about marijuana as medication

House Speaker Linda Upmeyer. (file photo)

House Speaker Linda Upmeyer. (file photo)

The top Republican in the legislature is making it clear she will oppose any attempt to legalize medical marijuana in Iowa this year. House Speaker Linda Upmeyer, a Republican from Clear Lake, is a nurse practitioner and she says it “makes sense” to have the federal Food and Drug Administration make that decision.

“I still really believe that the FDA is the arbiter of what is a medication,” she says, “and making sure that the safety, the quality — all those things is the same for any medication.”

Upmeyer says Iowa doctors worry they’ll lose their licenses write prescriptions if they advise patients to use marijuana as treatment for a medical condition.

“Physicians that hold DEA licenses have just a real bit of a concern or a large concern over whether or not that jeopardizes those at all,” Upmeyer says.

And Upmeyer says on January 20th of next year when a new president takes over, the federal approach to medical marijuana may change.

“There are a lot of unanswered questions out there, but I still believe the FDA is the arbiter of medication and how that is managed,” Upmeyer says.

One of Upmeyer’s fellow Republicans in the House has introduced legislation that would allow the cultivation of marijuana in Iowa — for producing cannabis oil to treat chronic epilepsy. That bill faces a February 19 deadline to win approval in a House committee to remain eligible for legislators to consider in 2016.

Concussion bill moves ahead in state senate


The Iowa State Capitol.

State lawmakers concerned about concussions among high school athletes moved a bill forward in the Iowa Senate Wednesday to make it harder for coaches to put an injured player back in the game without proper rest or evaluation.

There’s growing concern about the impact of untreated or repeat concussions on athletes from the amateur to the professional level.

Senator Tod Bowman, a Democrat from Maquoketa, says his son was removed from a wrestling match his junior year for a concussion. “My son wanted to return to action. That’s the constant battle coaches face where athletic trainers or other medical personnel have a little different perspective in life moving forward,” Bowman says.

Bowman says the trainer was present when his son was knocked out during the match and settled the issue about whether he would continue. “And she immediately evaluated him and said ‘you’re done son,'” according to Bowman.

The Senate bill would require a professional trainer to evaluate injured players at varsity competitions for the so-called collision sports of football, soccer and wrestling. The trainer would also notify the school’s athletic director if an athlete from a visiting team suffered a concussion. Trainers who attended the statehouse hearing told of coaches putting star players back in the game.

Skeptics wonder if there would be enough athletic trainers in the state to staff every varsity event — for example, on a Friday night when hundreds of teams are playing across the state.

Thanks to Joyce Russell Iowa Public Radio


Lawmaker to introduce bill allowing production of cannabis oil in Iowa

Peter Cownie

Peter Cownie

A West Des Moines lawmaker plans to file a bill today that would make cannabis oil more accessible for Iowans to use as a medicine.

Representative Peter Cownie, a Republican, talked about his decision to push the bill.

“As the father of a healthy 3-year-old son and a healthy 10-month-old son, my heart goes out the families and the sick who have tried everything in the past to help their children and loved ones to no avail,” Cownie says. “I believe it is time for the state of Iowa to act.”

Cannabis oil.

Cannabis oil.

The Iowa Legislature passed a bill that was signed into law last year that allows resident to possess cannabis oil, but those who need it for their children or their own health say it is difficult to get.

Cownie says his bill bans smoking marijuana, and only makes the oil legal. “Only cannabidiol for a variety of ailments — including epilepsy. And also will allows it to be grown and dispensed in the state of Iowa. That’s the problem that we had with the original bill,” Cownie says.

Cownie spoke at a news conference Tuesday and did not want to say a lot more about the bill until it is filed, and then he says everyone will get an opportunity to voice their opinion.

“I would ask everyone to keep an open mind on the bill. There are predispositions to the word marijuana of course. This doesn’t have anything to do with that,” Cownie says. “This has to do with the oil derived from the plant.”

He did not want to say how much bipartisan support he thinks the bill may have. “I know we have some legislative support, but it is also my own personal policy, I don’t speak for legislators personally. They all need to make their own decision on this, and hopefully we’ll find common ground,” Cownie says.

Steve Gaer

Steve Gaer

Representatives of “Iowans 4 Medical Cannabis” joined Cownie to talk about how the cannabis oil has helped them or their children.

Steven Gaer says his daughter’s seizures have been cut in half since she started taking the cannabis oil.

“This is amazing stuff with no side effects that we can’t understand why people aren’t doing more to understand it and help people get to it,” Gaer says, “because there are no side effects. It either does work or it doesn’t work, but there are no side affects to this medication.”

He says the medications his daughter started taking at nine months old to prevent seizures stopped her brain development, and she has the intellect of a four or five year old and she is 26. Gaer says the cannabis oil has helped his daughter to finally sleep through the night and she recently said a complete sentence for the first time.

“I tell people this is like non-alcoholic beer. Don’t tell me if we have non-alcoholic beer that people are going to drink and become alcoholics. There are no side effects to this medication — yet she has seen results we have not seen before. And she has permanent damage,” Gaer says. “I can’t imagine a family with a young child that could have access to this, that maybe that child could live a normal life.”

The Gaer’s get their cannabis oil from New York. Iowans 4 Medical Cannabis say a survey they conducted in December shows 76 percent of Iowans support legislation that would allow the legal production of medical cannabis for those with qualifying conditions.


Senate Democrats pass 4% increase in school spending

Herman Quirmbach

Herman Quirmbach

Democrats who control the Iowa Senate pushed through a bill today that would increase state aid to public schools by 4 percent for the 2017-18 academic year.

Senator Herman Quirmbach, a Democrat from Ames, is chairman of the Iowa Senate Education Committee.

“It is long past due that this body and our colleagues in the House, in cooperation with the governor, reinvest in Iowa’s education,” Quirmbach said. The House and Senate are still at odds over school funding for next year, so it’s unclear what a 4 percent increase would translate to in actual dollars for the 2017-18 school year.

But, Quirmbach calculates that over the last five years, when adjusted for inflation, Iowa’s per-pupil spending has increased by just $6. “Six dollars over five years…an increase of 0.1% — not per year — that’s total, over five years,” Quirmbach said. Quirmbach also cited the results of a survey that Democrats in the legislature sent to school superintendents.

“Over 90-percent of our school superintendents and principals are telling us that without a decent increase (in state aid), class sizes will increase — meaning that individual students, our children and grandchildren, will not get the individual attention that they need and that they deserve,” Quirmbach said.

Senator Amy Sinclair, a Republican from Allerton, said while she supports the effort to address school funding in a timely manner, lawmakers should resolve the dispute over spending for the coming school year first.

“For me, we need to make sure that we have an understanding of what we’re funding for (fiscal year) 2017 before I feel we can appropriately budget for FY 2018 because the one compounds from the other,” Sinclair said.

According to Sinclair, approving state aid to schools for 2018 before setting the funding for 2017 could ultimately hurt taxpayers. “They put us in a position of either overpromising and underfunding or passing those bills back on to property tax payers,” Sinclair said.

A House-Senate conference committee is set to debate school funding for the 2016-17 academic year. Senate Democrats also support a 4 percent increase for that year, while Republicans who control the House favor a 2 percent spending increase.


Governor: Democrat attempts to stop Medicaid privatization are ‘outrageous, political’

Governor Terry Branstad.

Governor Terry Branstad.

Governor Terry Branstad isn’t happy that Democrats in the Iowa Senate are pushing a bill that would stop the Republican Branstad’s plan to move the 560,000 Medicaid patients in Iowa into private managed care plans.

Former Governor Chet Culver, a Democrat, is holding two town meetings in eastern Iowa Tuesday to talk about the issue.

“Well I’m disappointed that Senate Democrats and former Governor Culver would make this a partisan political issue,” Branstad says. “I would point out that when the Lieutenant Governor and I were elected, Culver used over 440 million dollars of one-time money for Medicaid. The Medicaid program was in jeopardy because there were not ongoing funds being used to sustain it. We dug out of that big hole that he created.”

Branstad says Democrats are trying to torpedo a “thoughtful, systematic approach” to modernizing Medicaid. “I think it’s outrageous, political and that kind of partisanship should have no place in trying to deliver the best healthcare to the citizens of Iowa,” Branstad says. He says the privatization is something 39 other states have done and shown to be successful over the way things have been done.

“We feel an obligation to provide the best medical services to the people of Iowa, and to do it in a way that coordinates those services. We’ve seen the experiences of other states that have improved health. We’ve increase the number of people on Medicaid, but their health has not gotten better.” Branstad says.

Branstad’s administration originally planned to start switching the program on January 1st, but federal officials who oversee the Medicaid program ordered a 60-day delay.

(Note: this story was update to correct the time of the Culver events from Monday to Tuesday)