Newsletter: Rozenboom Report (4/28/2013)


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Week 15

The Iowa legislature is scheduled to meet through May 3, but it’s quite apparent that we will not be finished with our work then. As we approach the end of the 2013 legislative session, the majority of legislation comes in the form of large budget bills. Funding allocation has always been a point of contention between Republicans and Democrats because the parties have fundamental differences on how state money should be spent. I have always believed state money belongs to the Iowa taxpayer, and must be spent thoughtfully and wisely.

Senate Democrats continue to push inflated budgets through, and the legislation ends up in conference committees. As the meetings occur and negotiations continue, Senate Republicans will have a seat at the table and will advocate for sound budgetary practices. I have been named to the conference committee on Ag and Natural Resources appropriations where Senate Democrats are insisting on raising appropriations from $35.3 million to $63.5 million, a 79% increase. House Republicans are calling for a modest $1.0 million increase, so we’ll have to iron out the difference in conference committee. There are some one-time spending components of the increased spending that I do agree with because they will boost the new Nutrient Reduction Strategy, a voluntary program that puts Iowa in the lead position of controlling nutrient flow into the Gulf of Mexico. But I will not support any budget that includes this kind of spending increase.

The matter of Medicaid expansion still must be decided. The chart below provides an overview of how the Governor’s Healthy Iowa Plan provides insurance coverage to all low income Iowans, and also requires very nominal payments that can be offset with participation in wellness programs. This does require some personal responsibility for one’s own health, which is good public policy.

0-50% FPL51-100% FPL
Required Monthly Contribution$5$10
Annual Contribution$60$120
Upfront State Matching Contribution$60$120
Deductible$120$240
Copays 
       Non-emergency use of the ED$10
       Inpatient$50
       Brand name drugs when
       there is a generic available
$5
       Doctor visits$5
Healthy BehaviorPotential Bonus Contributions
       · Complete Risk Assessment$20
       · Annual Physical$20
       · Completion of Preventative
         Services
$20

The purpose of the Healthy Iowa Plan is to help Iowans become healthier for the long term through increased access to quality health care. The Healthy Iowa Plan focuses on quality outcomes, consumer education, and personal responsibility incentives. Iowans below 100% of the federal poverty level are encouraged to be cost-conscious consumers of health care and to participate in healthy behaviors. People above 100% of the federal poverty level will utilize the insurance exchange and their health insurance will be subsidized with tax credits. This model achieves both cost savings and healthier behavior.

The Healthy Iowa Plan offers local health care services to patients by requiring primary care doctors to be within 30 minutes or 30 miles from a person’s residence. The Healthy Iowa Plan ensures local access to care and provides for emergency transportation.

As we wrap up the legislative session I encourage all of you to feel free to contact me on matters of concern to you. I also encourage you to come up to Des Moines and visit me at the Capitol, the people’s house, for a first-hand look at the legislative process.

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