- Associated Press - Monday, December 10, 2018

Des Moines Register. December 6, 2018

Privatized Medicaid is here to stay; independent assessment will help Iowans make sure it works

The election of Gov. Kim Reynolds means privatized Medicaid is here to stay. She has refused to return control of the health insurance program for 600,000 people to the state, and it’s unlikely she will do so in the future.

That reality should prompt all Iowans, including privatization critics and the governor’s administration, to shift our focus to a common goal: Making sure Iowa’s privatized Medicaid works as intended for patients, providers and taxpayers. That will ultimately require diligent oversight and a commitment by this administration to transparency.

The most important step right now is obtaining an independent, comprehensive assessment of the impact of privatization. Iowans are understandably confused about what exactly has happened since for-profit companies took over the health insurance program in early 2016.



We have politically driven press releases. We have anecdotes about health providers closing their doors. We have news stories about disabled people losing care and private insurers receiving more and more taxpayer money. We have cost estimates from the Reynolds administration that are all over the board.

Republican State Auditor Mary Moisman recently released an audit claiming Iowa is saving money, but that audit is incomplete, narrow and feels political.

It did not consider how much the for-profit managed care companies owe in back bills to hospitals, clinics and other service providers. It did not explain how Iowa was achieving the supposed savings. The review period was set to end Nov. 7, which was not the end of the fiscal or calendar year, but was the day after this year’s midterm elections.

Mosiman lost in that election to incoming state auditor Rob Sand, a Democrat. He made Medicaid a central issue in his campaign and has vowed to review it. Yet Iowans may not trust his findings either.

Right or wrong, Iowa’s auditor, who is elected and affiliated with a political party, will inevitably be viewed as having an agenda on privatized Medicaid. And the office is not the best one to comprehensively tackle this issue anyway.

An analysis should be conducted by the nonpartisan Legislative Services Agency. It is familiar with the complexities of Medicaid and is not headed by an elected official. It has authority under state law to conduct a review if lawmakers request one.

An Iowa Code section specifically pertaining to LSA states lawmakers “shall independently and intensively review and oversee the performance of state agencies in the operation of state programs to evaluate the efficiency and effectiveness of the state programs and to consider alternatives which may improve the benefits of such programs or may reduce their costs to the citizens of the state.”

Our state legislators have failed abysmally at fulfilling this responsibility. Now they should direct LSA to conduct a review modeled after what’s known as a Legislative Post Audit (LPA), a performance audit conducted by the auditing arm of the Kansas Legislature.

Kansas, which privatized Medicaid in 2013, contracted with three private insurers and paid them a per-member-per-month rate to manage care. In other words, essentially exactly what Iowa did three years later.

By 2017, complaints were piling up, and the federal government was raising concerns. Kansas legislators decided they wanted to know how privatization impacted Medicaid costs, services and beneficiaries’ overall health. Enter the independent auditors.

They worked for a year, collecting about 200 million records related to beneficiary demographics, Medicaid claims costs, service use and health outcomes. They compared information before and after privatization and looked beyond simply costs and savings to taxpayers.

The final report revealed where the state needed to do a better job in gathering data and included important details about public dollars and patients.

For example, it found state payments to private insurers were hundreds of millions of dollars more than insurers were paying for health care claims. After privatization was implemented, use of nursing home care increased by 16 percent, and there was little evidence managed care’s emphasis on preventive care reduced hospital stays.

This is exactly the kind of nonpartisan, comprehensive information Iowa needs about this state’s privatization of Medicaid. Without it, we cannot honestly evaluate what is happening or how to move forward.

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Fort Dodge Messenger. December 6, 2018.

Iowa Central students show spirit of giving

The cynics in our world are quick to assert that college students live in a self-indulgent, self-centered world where truly being a part of the community where the college is located is simply not a priority.

For some students, that may be true.

It’s certainly not the case, however, for the Iowa Central Community College students who work hard to orchestrate a service project called “Share What You Wear.” Their commitment to this charitable undertaking illustrates that finding time to help make the world just outside the academic halls a better place is very much a priority for many young folks.

Saturday, Iowa Central students welcomed hundreds of area residents to the 16th annual “Share What You Wear” event at the Career Education Building. This undertaking has a quite serious purpose: to allow people in need to obtain toys, clothing and household items. For those in our town experiencing economic troubles, this endeavor is of huge importance.

The project began as a joint effort of the Iowa Central Student Senate and Phi Theta Kappa. It has grown to involve the entire campus community.

The college years are filled with exciting opportunities to explore many fields of knowledge. That so many Iowa Central students also see this as a time to be giving members of the larger community is impressive evidence that our area’s young adults most definitely have their priorities in very good order.

The Messenger congratulates everyone involved in making this year’s Share What You Wear undertaking another outstanding success.

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Quad-City Times. December 6, 2018

Bond issue wrong way to fund facilities

The $30 million Bettendorf GO bond referendum is an unnecessary tax increase wrongly put on the shoulders of Bettendorf taxpayers. The bond includes the administration’s “Wish List.” While I don’t oppose any specific project on that list, I do oppose asking taxpayers to vote for and pay higher property taxes to complete projects immediately.

According to the district’s own timeline, all projects would be completed in 3 to 6 years while taxpayers pay the debt for the next 20. In a society plagued by the need for instant gratification, sadly our district has fallen victim to this mentality.

The district should plan, prioritize and complete all projects using the available taxpayer-funded sources and avoid further burdening homeowners with higher property taxes.

The Iowa Local Option Sales and Service Tax (LOSST) and Physical Plant and Equipment Levy (PPEL) are the available taxpayer-funded resources that school districts can use to maintain, modernize and expand their buildings. Using these funds eliminates the need to increase property taxes. These funding sources have been heavily utilized in recent years while enrollment has stayed flat in this landlocked district. The district is now going into long-term debt for the first time two decades.

Had the district opted to do renovations/remodeling of the existing elementary buildings instead of building two new schools, it would have over $15 million dollars at its disposal to cover the cost of much of this GO bond proposal.

The new school building being constructed behind Mark Twain is nearly $3 million over original estimates and the grand total has yet to be seen. Several years ago, this district was debt free. Now we’re looking at $35 million already spent and they’re asking for another $30 million. This is nothing more than taxing us twice for school building projects.

In September, we received updated property tax statements after the re-assessment. The average increase in Bettendorf was 10 percent. This bond increases taxes for every homeowner in the district by an additional five percent for the next 20 years. This district has financial difficulties in its future unless spending halts and focus placed on operating within construction and general operating budgets alike.

All Bettendorf School buildings have secure entrances. According to administration, the additional changes to the secure entrances at Norton and Hoover are the first priority and will be completed regardless if the bond passes. Safety shouldn’t be used to gain support for this GO bond. Maximum safety is the foremost expectation and taxpayers should never be expected to “vote for” or “pay more taxes” for the safety of students.

(asterisk) 54% funds upgraded finishes, gym renovations, office additions, district wide maintenance and parking lot resurfacing;

(asterisk) 37% funds athletic spaces;

(asterisk) 9% directly supports academics;

These numbers should be reprioritized. Priority must be placed on properly maintaining buildings but most importantly on enhancing academic quality through additional STEM and career-ready programming, as it impacts the future workforce in this community.

The district openly stated, the “look” of our buildings and classrooms persuades new families to attend our schools. This bond is not so much “investing in our students’ futures,” as it is investing in the “look” of our classrooms.

I believe the quality of education and the superior teaching staff inside Bettendorf classrooms is what truly matters.

Make your voice heard and vote “NO” on Dec. 11.

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Sioux City Journal. December 6, 2018

Truce in tariff war provides hope

An encouraging sign for farm states like Iowa emerged in recent days with news of a 90-day truce in the tariff battle between the United States and China.

President Trump announced the agreement, which began on Dec. 1, last weekend at the G-20 summit in Buenos Aires; for the first time, China’s Commerce Ministry on Wednesday acknowledged the 90-day break.

In remarks to the Iowa Taxpayers Association’s annual meeting in Altoona last week, two members of Gov. Kim Reynolds‘ administration - Debi Durham, Iowa Economic Development Authority director, and David Roederer, Department of Management director - underscored the negative impact on Iowa’s economy of international trade uncertainties.

Durham said the clouds hanging over trade are preventing the state from reaching full potential for growth.

“We need to work through this trade thing because I think that’s the only thing that is holding us back,” Durham said. “This is the one that keeps me up at night.”

A recent Iowa State University report said Iowa farmers could lose up to $2.2 billion from U.S. trade wars with China and other nations, producing a ripple effect on state tax receipts, jobs and other industries.

Consider the potential impact on soybean growers, who produced a record crop this year, alone. The U.S. sold some 33 million tons of soybeans to China in 2017, or nearly one-third of that country’s soybean imports. China buys roughly half of U.S. soybean exports, or about $14 billion annually, and roughly one in three rows of soybeans grown on the nation’s farms ends up in China, according to the American Soybean Association, but the Chinese all but stopped purchase of U.S. soybeans this year in response to Trump administration tariffs.

As we have said before, all farm state officeholders must use whatever clout and influence they possess in ratcheting up pressure on the Trump administration to end the trade war with China. They should be in the ear of President Trump and members of his administration every day. This isn’t (or shouldn’t be) about political considerations, it should be about what’s good for the livelihoods of agriculture producers and the agriculture economy.

We join with all Iowans, as well as Nebraskans and South Dakotans, in hoping the three-month cease-fire is the beginning of the end to the U.S.-China trade war and the potential it holds for economic calamity in farm country.

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