The Clinton Herald, Clinton, Iowa

March 11, 2013

Mental health tops legislative discussion

By Katie Dahlstrom
Herald Staff Writer

CLINTON — Local legislators focused on the ongoing issues surrounding mental health funding and Medicaid expansion during the Saturday morning legislative coffee sponsored by the Clinton Area of Commerce.

Rep. Mary Wolfe, D-Clinton, Rep. Steve Olson, R-DeWitt and Sen. Rita Hart, D-Wheatland spent an hour discussing issues with approximately 20 people who attended.  

Wolfe explained that legislators continue to work to get some supplementary transitional funding to counties like Clinton as mental health officials grapple with the mental health redesign.

A bill that passed through the House and is working through the Senate would divide $11.6 million throughout different counties to ease them through the transition as the mental health funding mechanism is put into place.

However, Clinton County was not one of the counties designated to receive any funds.

Hart encouraged people to continue sharing their stories and communicating with her and fellow legislators about the impacts the redesign will have on mental health services so those problems can be considered when changes to the system are made.

“It's still a work in progress. It has not been handled well. I think it's frustrating to everyone. And that's a good thing maybe that everyone recognizes that we need to fix this,” Hart said “We need to know exactly how these things that we're saying works on paper ends up working or not working.”

Wolfe said she believed because of the communication between local mental health officials and the legislators that they have been able to spread the word about the negative effects Clinton County will experience.

“I think there is a real understanding out there at this point that for Clinton losing the ability to fund Bridgeview at the level we have been is a huge problem,” Wolfe said.

Wolfe also brought up Medicaid expansion during the forum. Governor Terry Branstad has said he will not expand Medicaid in Iowa under Pres. Barack Obama’s Affordable Healthcare Act.

“Be aware that despite the fact that nationwide all sorts of governors, Republican governors are getting behind Medicaid expansion because they recognize that it is the right thing for their state, for their people, despite the fact that across the state there's just hundreds of organizations that are very much behind Medicaid expansion, and not just Democrats, there's all sorts of Republican organizations, our governor is still saying ‘nope, we're going to do it my way,’” Wolfe said.

Under the federal plan, 150,000 uninsured Iowans would receive coverage. Branstad’s plan, the “Healthy Iowa Plan,” would reach 89,000 uninsured Iowans, although the details of the latter are not as clear. Branstad’s plan would also require participants in the program to contribute on a sliding scale based off income.    

“That's what I don't understand. How long have we known this is on the table. Why is that plan not fleshed out? The other thing that doesn't make sense to me is his plan is going to cost Iowa money,” Hart said.

Under the federal expansion the state would be reimbursed 100 percent for the first three years and 90 percent in the following years. Branstad’s plan on the other hand would require $23 million coming from the state’s general fund. This is slightly more than the Iowa Care program, which is set to expire.

The federal funds for Medicaid would be around 58 percent under Branstad’s plan.   

The plan would require federal approval before it could be enacted.  

“It’s my understanding he’s got approval for his plan,” Olson said. “As Mary said, various people have different opinions. I have had private industry tell me well, if the nonprofits are in favor of this maybe they should be switched over to paying taxes like everybody else. So you have that debate.”

“So there’s a lot of pros and cons and this will not be an easy issue,” he added.  

Branstad has said he would like the program to be active by January of next year.

“If he won't OK the Medicaid expansion, my understanding is there's nothing we can do about it,” Wolfe said. “So we're going to have to hope to hell that his plan actually will work and that we have the money to make it work and that it will be better than nothing.”