Iowa Advances Health Reform Agenda

Prior to last Monday's White House health care forum in Des Moines, Iowa, one of five regional forums being held across the country, the Iowa Senate passed two significant health care reform measures - one symbolic and one substantive.

Resolution for Federal-State Collaboration on Health Reform: The Iowa Senate passed a resolution calling on "state governments and the federal government to collaborate with one another to reach the goal of providing quality and affordable health care to all Americans." The resolution, authored by Sen. Jack Hatch, included a specific list of "guiding principles" that should be part of any national health care policy, including:

  • cost containment strategies - such as improved chronic care management and national electronic medical records

  • access to coverage for all - through public and private options and limiting a family's total health care costs to an affordable percentage of household income

  • improved quality - including comparative effectiveness research and eliminating health disparities

The resolution envisions a strategic federal/state collaboration to solving the health care crisis in America and calls for federal reform that supports "state innovation by creating robust national standards that serve to raise the floor of state action, rather than limit state efforts to achieve the goal of quality and affordable health care for all."

Moving towards Comprehensive Health Care: The Iowa Senate followed the resolution with passage of SF 389, one of the most comprehensive health care bills moving in states this year. Also sponsored by Sen. Hatch, the legislation builds on a 2008 law that created a path for Iowa to achieve health care for all kids and address health care cost and quality. Making a big step towards those goals, SF 389 will extend eligibility for public programs to children in families up to 300% of the poverty line, covering 30,000 of the state's 40,000 uninsured kids, and establish a "soft" mandate that eligible children be signed up (there are no penalties for parents who fail to enroll their children). Funding for the expansion comes from $8 million in state funds and increased federal support through the SCHIP reauthorization and the federal stimulus package.

Notably, SF 389 includes substantive measures to rein in prescription drug costs, improve the quality of care, and design more options for coverage for businesses and families. Highlights include:

  • The "Iowa Insurance Exchange" charged with designing more affordable coverage options provided through public and/or private health plans

  • A health care workforce support initiative and workforce fund under control of the College Student Aid Commission

  • A prescriber education program to provide medical professionals with scientific and evidence-based clinical information about medications

  • A prohibition on gifts to medical professionals from the pharmaceutical and medical device industries

  • Strengthened privacy protections in the use of prescription-use data (related to industry data-mining), and

  • Transparency provisions, including the requirement that for-profit hospitals and nursing facilities submit annual reports akin to 990 forms provided by non-profit facilities, greater reporting of hospital patient flow and related information, and a health care quality and cost transparency workgroup to identify ways to improve quality and cut health care costs.

As a sign of what's to come in the national health care debate, Republicans en masse opposed SF 389 and charged, "This bill leads us down a pathway to socialized medicine." Sen. Majority Leader Mike Gronstal dismissed the accusation as "tired", an apt description of the hackneyed accusation conservatives have made against substantive reform since at least the Truman Administration. What shouldn't be missed in the political debate surrounding the measure is that, if enacted, SF 389 will result in Iowa's businesses and families having more options and choices for coverage - a key priority for voters. SF 389 is now before the Iowa House.

Senate Resolution 13 - Encouraging a Federal/State Collaboration to Achieve Quality, Affordable Health Care for All
Progressive States Network - Strategies to Extend Coverage to Uninsured
Stateside Dispatch - Rx Policies: Cut Health Care Costs and Promote Broader Health Care Reform
Progressive States Network - Implementing the Recovery Plan: A Resource Guide for State Legislators and Advocates