April 20, 2007, was a long and demanding day for me. As the House Chair of the Health & Human Services (HHS) Appropriations Sub-committee, I was the floor manager of HF 909, the nearly $1.5 billion budget bill that funds the Departments of Elder Affairs, Public Health, Veterans Affairs, Human Services and the Iowa Veterans Home. The debate lasted for over eight hours. Unfortunately, partisanship reared its ugly head in a budget bill that has been relatively free of political bickering in the past few years. The bill passed on nearly straight party lines 53-44, with three legislators absent.

The good news is that the Iowa House approved a plan that will expand health care coverage to over 17,000 Iowans who currently do not have it. The budget we passed will expand health insurance to 10,750 additional children and 6,250 of their low-income parents. Currently, over 265,000 Iowans do not have health insurance, so this is a start toward ensuring health care for all Iowans.

After a number of years of inaction on the part of the Iowa legislature, we were able to fix a festering problem by approving a $19.6 million allocation of new money to counties to help them provide services to Iowans with mental illness, developmental disabilities and mental retardation. This problem actually began in 2002, when the Iowa legislature scooped $18.8 million from the fund balances of counties; those services have been in a crisis mode ever since. We will need to monitor these services and work in partnership with counties to make certain that basic services for people with disabilities are being provided.

One of my goals as the Chair of the HHS budget was to put more emphasis on prevention. That goal is reflected in the following appropriations: an additional $9 million for tobacco cessation and prevention; expanded substance abuse treatment; increased allocation for child abuse prevention efforts; assistance to keep seniors in their own homes; childhood obesity prevention; and, for the first time, funding for the Iowa Consortium for Comprehensive Cancer Control (ICCCC).

In 2001, the Iowa Legislature commissioned a detailed study of the impact of cancer on the state. That report, The Face of Cancer In Iowa, led to the formation of the ICCCC. The Consortium includes over 100 people representing approximately 50 entities. ICCCC membership includes researchers, legislators, insurance companies, health care providers, faith-based organizations, hospice agencies, pharmaceutical companies, cancer centers, cancer survivors, health systems, voluntary health organizations, state and local public health agencies, schools, and a variety of other agencies with interest in cancer control. The goal of ICCCC is, whenever possible, prevent cancer from occurring; when cancer does occur, find it in its earliest stages; when cancer is found, treat it with the most appropriate therapy; assure that the quality of life for every cancer patient is the best it can be; and move research findings more quickly into prevention and control practices. In other words, make cancer something we can live with, rather than die from.

The HHS budget provides services for Iowa’s most vulnerable citizens: newborns, frail elderly, people with disabilities, veterans, people with chronic health problems, and children who are removed from their homes by the juvenile court and are wards of the state. This budget represents nearly 20% of the total state budget.

A large part of the HHS bill is the funding of Medicaid, much of it required by the federal government. Over 10% of Iowa’s population relies on Medicaid to obtain their health care. On any given day in Iowa 325,000 people utilize Medicaid. Over a span of one year, about half a million Iowans use Medicaid.

After carefully considering priorities and making very difficult decisions, our committee brought HF 909 to the floor of the House within the planned budget target. When our spending remains within established targets, we achieve a balanced budget, which is something that Iowa law requires.

As I reported in an earlier article, every dollar of the revenue raised by the increase in tobacco taxes, estimated to be $127.6 million, will be used for health care only. We had to make some very difficult choices in order to complete this budget, but I believe we now have a HHS budget that is fiscally responsible and goes a long way in addressing the health care needs of Iowans. HF 909 now goes to the Senate for consideration.

You can write me at the State Capitol, Des Moines, IA 50319; call 515/281-7328 or e-mail me at ro.foege@legis.state.ia.us.

Ro

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