Town Hall meeting held in WC
Area residents pose questions on wide range of issues
About 100 people gathered at the Webster City Middle School to hear what the legislators had to say and to pose questions. Many of those present brought “Agree/Disagree” signs let the legislators know how they felt on certain topics. The meeting was hosted by the Webster City Area Chamber of Commerce.
Behn and Bacon introduced themselves and talked about a couple of bills under consideration.
“House File 203 is the one that’s going to allow federal dollars to come to the state and then the state go to the local. It should free up roughly 15 to 20 percent for roads and bridges,” Behn said. “Those are federal highway dollars. I think that will be good for the tax payer.”
He also highlighted Senate File 404, called the Right to Try Bill, which would allow drugs that have passed through phase 1 of Federal Drug Administration trials to be used.
“If you have an illness and your doctor agrees its a good idea to try a drug, it’s going to let you try it ahead of time,” he said. “They can try those, see if it does a good job.”
Bacon said the Revenue Estimating Conference figures have been released.
“We’re about another $107 million shy to finish this year’s budget,” he said. “When we came into session this year, we thought we were going to be about $117 million short and then we found out last week we would be short another $107 million.”
He said the previous shortfall was addressed with a deappporpriation bill.
“That was tough. Lost a lot of sleep over that,” Bacon said. “But this time, we’re going to reach into our cash reserves — our rainy day funds.”
Bacon said that means “everything will be on the table” for the next budget, including tax credits.
Lori Rathbun, chief executive officer of Van Diest Medical Center, expressed concern for the potential 14 million people who could lose health care by proposed changes to Medicaid.
“For our hospital, Medicaid represented $4.9 million in 2015 and 14 percent of the hospital’s revenues,” she said.
“We’ve become very concerned when we’ve already had to take huge cuts in reimbursement, over $500,000 last year and we expect the same this year,” she said.
More than the effect to the hospital, Rathbun said the hospital’s patients are at risk.
“If this legislation were to go through, we’re looking at more and more uninsured folks. They don’t get preventative medicine. They show up in our ER,” she said.
Rathbun said that while the hospital is required to treat these patients, it does put an additional cost burden on the health organizations along with increasing health factors on patients.
“I’d like to know how you’re going to protect these people and the hospitals that are the backbone of our communities,” she said.
Bacon said related to that question was the defeated plan concerning changes to the Certificate of Need, a regulatory review for health care facilities.
Bacon said the plan would have opened the door to for-profit entities who could “cherry-pick their patients.”
“If you’re going to do that and if you’re a for-profit organization, you’re not going to take Medicaid patients at all,” he said. “That puts more pressure back on county hospitals. You would be forced to take all the Medicaid and Medicare patients who might not have supplemental insurance to go with it.”
Bacon said the federal government health care issues are going to trickle down to the states.That’s one of the reasons the state opted for managed care organizations.
“This was going to save Medicaid,” he said. “That’s what we were told. It has got to be readdressed.”
Rathbun concurred that the hospital is still awaiting large reimbursements from the MCOs. Shelby Kroona, Hamilton County Public Health administrator, told the two legislators that her agency has not received payment in over a year from one MCO.
“AmeriHealth Caritas has also tossed another monkey wrench into the care we give people in the county. They are the only managed care organization that requires us to prior approve every single procedure for every single client,” she said. “They are causing us to fall outside the federal guidelines for home health agencies. We don’t have two more years. We will lose our certifications.”
Kroona said the legislators needs to bring providers together to offer “honest conversations about what is happening” in the state.
Behn said he is forwarding all complaints of this nature directly onto the governor’s office.
“We’re going to be looking at this issue and we’ll need feedback from you folks when the study comes back as to what we can do,” he said. “Our providers need to be paid for the services provided. And not at the expense of the patients.”
A letter from a mother whose son is served by an MCO was read aloud. She noted that her son’s budget for services he needs has been slashed by 37 percent. Behn asked for a copy of the letter to pass on to the governor’s office.
Julie Ehrsmann of Stratford asked about the cost of community colleges in Iowa compared to those in surrounding states. She talked about a student who was considering community colleges in Iowa, Minnesota and Kansas.
“He told me that he could go Kansas for one-third of the cost and he could go to Minnesota for close to half the cost of tuition in Iowa,” she said. “What do I tell this person to say he should come to Iowa?”
Behn said he was unaware of the discrepancy in costs between the states.
“That’s new information for me,” he said. “What I can tell you is I’ve been telling a lot of people that community colleges are the best bang for the buck in the state.”
He said he would investigate how colleges in surrounding states are able to offer lower tuition.
“It’s because of state appropriations, I can tell you that,” Ehrsmann said.
“Why stay in Iowa? Well, it’s a great place,” Bacon said. “We’re working on tax reform so we can keep our graduates here. There has been a brain drain.”
Asked why there have been cuts to education, Bacon said,“I don’t know how we can say there have been cuts to education. We appropriated another $40 million for K-12. Since I’ve been in the House, we have appropriated almost $750 million for K-12. I don’t know how you can call that a cut. That’s new money.”
Those present also asked about school choice and education savings accounts.
“I support educational savings accounts,” Behn said, adding “I think they’re a good way to incorporate competition and competition benefits everybody.”
He added that the concept of education savings accounts is designed to encourage greater parent involvement.
“It’s not a payment to a school. It’s a payment to a parent and the parent can then decide which school to choose,” he said.
Behn also said he didn’t believe that monopolies “bring out the best cost or the best innovation.”
“We have guidelines at a federal level that says you can’t have a monopoly,” he said.
“But education is not a business,” said Karen Mason, a teacher from Webster City. “That does not apply to education.”
Polly Doolittle asked how the legislature is able to write a budget without knowing how many people actually live in the state.
“You’re dealing in education and medical issues with illegal immigrants and refugees. It’s a huge obligation and a huge drain against our own children, grandchildren and elderly parents,” she said. “We are educating, supporting and giving medical care to people here illegally.”
She also asked if Iowa was a sanctuary state for immigrants.
“We’re not a sanctuary state,” Behn said. “There are places that are, but there is some effort to curtail that. It’s not appropriate to consciously disobey the laws.”