On April 7, Iowa State Senator Tim Kapucian and Representative Dave Maxwell met with their constituents in Grinnell for the third and final Legislative Coffee, hosted by Grinnell’s League of Women Voters. The state legislature is scheduled to end its session on April 17, its 100th day in session, when the per-diem payment of legislators will expire. However, the legislature may go into over-time if bills still on the floor are not resolved by the deadline.
With the session ending, constituents expected an opportunity to let their legislators know what concerns they had over bills still on the senate and house floors. However, a presentation by Jerry Foxhoven, Director of the Iowa Department of Human Services (DHS), delayed audience questions.
Senator Kapucian invited Foxhoven to speak in Grinnell after receiving several questions about Medicaid and the DHS budget at both the Feb. 3 and March 3 Legislative Coffees.
“When we get a question from a constituent, we go to our staff people, and then they go to the Department of Human Services. So, I’d like to get everybody connected directly to the people that can help them. I don’t want to have anything lost in translation,” Kapucian said as he introduced Foxhoven.
Foxhoven assumed the role of director in June, after Iowa’s Medicaid system had already been privatized and put in the hands of managed care operations. Foxhoven spoke for half an hour, focusing on the positives of the switch to MCOs, citing the low numbers of complaints received by DHS as evidence of success.
“They used to talk about saving you money, that’s kind of the wrong discussion. It’s about sustainability … [so that] 20 years from now we’re still able to provide that care,” Foxhoven said.
Some attendees did not share Foxhoven’s positive outlook.
“If you asked anybody who takes care of patients if it was a good idea to privatize Medicaid all at once, everybody said ‘no, this is a bad idea,’” said Laura Ferguson, lifelong Grinnell resident and family physician. “Now we are left with this debacle that doesn’t seem to be getting better on the ground. … When the governor says there’s been a few bumps in the road, and you say it’s been a little rough, that undervalues the lived experiences of my patients that can’t get care.”
Foxhoven’s response to Ferguson’s comment acknowledged mistakes made, but he stated that he prefers not to dwell on the past. Currently, rather than try to change the state’s Medicaid system, which depends on managed care organizations, Foxhoven is awaiting the next federal budget from President Trump. A new federal budget would likely necessitate changes to Iowa’s Department of Human Services’ own budget, bringing about changes to the system.
“I’m going to push back a little bit on this not looking back to the mistakes that were made, because those mistakes had costs,” said Kirsten Klepfer, a member of Capstone Behavioral Healthcare’s Board of Directors. “Those [mistakes] have costs to a community mental health center that is serving the community people well and in a financially sustainable way. … The cost of those mistakes is threatening that.”
Foxhoven reiterated the need for more money to fix problems. “We’ll be asking for more money just to provide the benefits we need to provide, a lot more money,” he said.
After Foxhoven’s presentation and the questions directed at him filled the hour that was allotted for the event, Emily Guenther ’07 requested that the legislators stay an extra half hour to answer questions that did not relate to DHS.
Senator Kapucian and Representative Maxwell agreed, answering several questions, two of which referenced proposed budgets and questioned tax cuts. The legislators asserted several times that, nearing the end of session, it is hard to know how current bills will play out.
“When we come into session, I don’t know what is going to happen … and now I’m almost in the dark towards the end of session,” Kapucian said.
The Iowa State Legislature’s session is scheduled to end April 17. State primaries will be held on June 5, although Maxwell is running unopposed and Kapucian is not up for re-election. General elections will be held on Nov. 6.
