The Medicaid system provides health care coverage for tens of thousands of Iowa's elderly, disabled and poor. Each year the State of Iowa spends over $600 million, about 12% of the state budget, which is matched by two or three times that amount in federal funding.

Medicaid costs have grown by leaps and bounds over the past several years due in large part to the aging of Iowa's population and the national economic downturn that have caused more people to be without health insurance. The Legislature has struggled to meet the state's share of those needs, even borrowing from other health care programs.

Those efforts suffered a major blow when the Bush administration announced a $66 million reduction in federal support to Iowa. That $66 million was parlayed into nearly $200 million worth of health care for Iowans. I was one of the five House members assigned to find a way to recoup those funds, the loss of which would mean either spending $66 million more in scarce state funds or cutting existing medical services. Other members of the sub-committee included Carroll, Heaton, Smith and Upmeyer.

I spent most of the past three weeks working with Democratic and Republican legislators, together with Governor Tom Vilsack and Department of Human Services officials, as we crafted an innovative strategy to not only make back the lost federal aid, but to expand eligibility to even more Iowans. With this new strategy, we restructure existing medical services and resources at University Hospital in Iowa City, Broadlawns in Des Moines, and state mental health institutions into a new Medicaid program for uninsured adults under age 65. This in turn qualifies Iowa for additional federal money to offset the other cuts by the Bush administration.

An Iowan earning up to $19,140 (or a couple earning no more than $25,600) would be eligible for the new health care program. Benefits would be limited primarily to hospitalizations and related care, would require a small monthly premium, and would be provided through University of Iowa and Broadlawns hospitals.

The new plan is subject to federal approval, but may well serve as a model for other states as they cope with rising health costs. Iowa is now considered the laboratory for this experiment in a more flexible approach to Medicaid in partnership with the federal government. It is an example of what can be accomplished when lawmakers put aside partisanship and work toward a common goal.

It was gratifying that after many hours and days of work on this new approach to Medicaid, the bill passed 100-0. It is rare that a proposal doesn’t pick up at least a few negative votes.

In other news last week, controversial amendments being considered in the Senate to the Iowa Public Employee Retirement System (IPERS) drew angry responses from public employees. Fortunately, they were withdrawn from consideration and not adopted. A Senate committee had proposed that new public employees hired after July 1, 2005 would have been unable to retire under the existing "Rule of 88" (age plus years of service) and would have had their retirement benefits based on their top five years of average wages, instead of the current top three years. It is likely there will be no changes this year to the Rule of 88 or to the benefit wage calculation.

In contrast to the Medicaid bill passing in the House without a negative vote, some mean words were being said in the Senate last week. Assistant Senate Republican Leader Mark Zieman, complaining about funding requests from teachers, school board members, prison guards, police officers, sheriffs, city and county elected officials, and other public servants said, “Every fall, I get to meetings and here they are, the bottom feeders, out there with their hand out."

We face serious problems, but we can find solutions if we have the will and the ability to work together. Iowans will judge this session on our ability to compromise and reach consensus. I cannot believe that my constituents prefer disrespectful name-calling rather than finding common ground. We must work together to make Iowa the best place to live, work and raise a family.

You can write me at the State Capitol, Des Moines, IA 50319; call 515/281-3221 or e-mail me at ro.foege@legis.state.ia.us.

Ro

Another Internet Presence Provided by Kelly Webworks.