House approves $1.94 billion for health, human services

DES MOINES — The Iowa House approved nearly $2 billion from the state general fund that — when coupled with federal funds — will direct more than $5 billion to state health and human services.

On a party-line vote, 54-44, majority Republicans approved $1.94 billion to fund the state’s Departments of Aging, Public Health, Human Services and Veterans Affairs and the Iowa Veterans Home. That’s an increase of $30 million from the current fiscal year.

House File 766 will support 4,605 full-time equivalent jobs in those departments, an increase of 254 from the current fiscal year.

The budget will “fund the neediest Iowans’ needs,” said Rep. Joel Fry, R-Osceola, chairman of the House Health and Human Services Appropriations Subcommittee.

The budget includes a supplemental appropriation of $150 million for the Medicaid program in the current year.

Fry explained there has been more growth in Medicaid since privatized managed care began and less revenue coming from the trust fund. It is his hope that budgeting based on actual managed care experience would not require such a large supplemental appropriation in the future.


Also Thursday, the House unanimously approved $404.7 million for the Department of Transportation, an increase of $15 million, which matches the governor’s recommendation.

Senate File 600 supports 2,730 full-time equivalent positions in fiscal 2020, an increase of eight jobs.

The budget includes almost $52 million from the Road Use Tax Fund and $353 million from the Primary Road Fund, plus $8.7 million from the Primary Road Fund to replenish the supply of salt used for winter road operations.

Some 47.5 percent of the Road Use Tax Fund — collected mainly from the gas tax and vehicle registration and title fees — goes to the Primary Road Fund, operated by the state DOT; 24.5 percent goes to the Secondary Road Fund and 8 percent to Farm to Market, operated by counties; and 20 percent goes to the Street Construction Fund for cities.


Representatives also voted 99-0 to repeal the Honey Creek Premier Destination Park Bond Program.

The Honey Creek Premier Destination Park Authority and the Honey Creek Premier Destination Park Bond Fund was created by the Legislature in 2005. It was authorized to issue up to $28.0 million in bonds for the development and expansion of the park near Lake Rathbun.

The bonds were redeemed June 1, 2016, and state law requires the authority to dissolve the bond program no later than two years after the date of final payment of outstanding bonds.


Although they voted against the budget, Democrats found a few things in it to like.

“I’m not going to deny there isn’t some good provisions within this budget,” said Rep. Lisa Heddens, D-Ames, who offered several amendments Republicans rejected.

Democrats liked the 29 additional social workers, funding for rural psychiatry, critical access hospitals and nursing home support, starting a hotline for children’s mental health and reducing the wait-list for children’s mental health.

But the bill “doesn’t solve the problem that’s before the state,” House Minority Leader Todd Prichard, D-Charles City, said. “It’s not just a problem. I would classify it as a crisis.”

For more than five hours, Democrats read letters and emails from people complaining about the quality — or lack — of care they and their families were receiving under the state’s 3-year-old Medicaid managed care program.

They offered about two dozen amendments covering family planning, Medicaid, suicide prevention, minority impact statements, auditing pharmacy benefits manager and the state Medicaid managed care organizations, reducing sexually transmitted diseases, child care and transferring the Department of Mental Health to the Department of Public Health.

Most of the amendments were ruled not germane. Others were voted down.

“I’m not generally a one-issue person,” Heddens said, “but when it comes to disability services and supports, when it comes to the managed care fiasco that we have, I am a one-issue voter.”

However, Fry suggested Democrats mischaracterized the quality of care the state is providing.

“I suggest we have excellent health care providers,” Fry said. “It’s been suggested that we might be turning a blind eye to Iowans, that we’re not improving health in this state in this budget. I could not think of anything more false.

“If you vote against this budget bill, I would suggest to you that you are turning a blind eye to Iowans because you now are voting against a bill that supplies and provides care and resources to most vulnerable.”