Before the legislature can adjourn at the end of April, the budget for the fiscal year starting on July 1, 2007, must be approved. The House has begun that process, passing the second of nine appropriation bills last week. As Chair of the Health & Human Services Appropriations Sub-committee, most of my time is focused on that appropriations bill, which was passed out of the sub-committee last week. That particular budget represents about 20% of the total state budget, with the largest part of the resources going to Medicaid. The bill will now go to the House Appropriations Committee before going to the floor of the House for debate.

As I reported to you several weeks ago, the increase in tobacco tax of $1 per pack of cigarettes is estimated to generate $127.6 million in revenue. All of the new tobacco revenue will go to fund health care. The bill we passed last week will spend that money to help Iowans quit smoking, to expand health insurance for children, to fund rural health care clinics and for other health-related purposes.

Our Medicaid budget growth, together with the projected increases in hawk-i, the Iowa children’s health insurance program, is $141 million. When you hear statements that the tobacco tax is not being used for health care, you can be sure that is just not true. We have far more health care costs than we have new tobacco tax revenue coming into the state coffers.

What you may hear is that there are no Medicaid provider increases built into the Health & Human Services budget bill. That is a fact. However, not all of Iowa’s health care obligations are paid out of the Health & Human Services appropriations bill. My colleagues and I are looking for ways to fund some other health needs through other appropriations bills, such as the Health Iowans Tobacco Trust fund, which was created when state sued and received a settlement from the tobacco companies.

In addition to looking for ways to increase medical providers reimbursement rates, we need to find the means to fund the county mental health systems, increase funds for serving seniors in their own homes, and reduce the number of children who are on waiting lists for mental health services, to name several still unmet needs.

In another health-related issue, Iowa’s rate of lead poisoning in children is very high, four times the national average. The problem occurs in both urban and rural Iowa. One problem is that more than half the houses in Iowa are older homes in which lead paint was used. Right now, almost 70% of Iowa children are tested and about 7% of those children have lead poisoning. Lead poisoning can lead to learning disabilities, behavioral problems and even death. Last week, the Iowa House voted 93-5 to pass a bill that requires all children entering school in Iowa to be tested for lead poisoning by the age of six. In addition, the bill encourages parents of young children to have a blood lead test by the age of two. The state will need to pick up the cost for those families who do not have a way to pay for this test.

In our attempt to help small businesses control the high cost of health care, the Iowa House unanimously approved the formation of health insurance pools. This legislation allows trade associations to form health insurance pools for small employers. By banding together, they will qualify for lower insurance rates and will be able to provide coverage for their employees. A small employer is one with between two and fifty full-time employees who normally work at least 30 hours per week.

This has been a very productive session. We have already accomplished a great deal, and I am hopeful that we are right on track to adjourn on time at the end of this month.

Thanks for your letters, e-mails, and phone messages. It is good to hear your thoughts and concerns on the various pieces of legislation before us. You can contact me at the Iowa Legislature by e-mail, ro.foege@legis.state.ia.us or calling me at 515-281-3221.

Ro

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