Iowa House passes HHS budget, funds Medicaid trend and provider investments

The Iowa House on the floor passed House File 2782 on final reading, approving state general-fund appropriations for the Department of Veterans Affairs and the Department of Health and Human Services, including Medicaid, child care, child welfare, behavioral health and other related programs.

Representative Meyer, sponsor of the amendment that became the House position on the HHS budget, told members the measure appropriates $2,560,000,000 in state general fund and, with federal matching funds, totals more than $10,500,000,000 directed toward Medicaid and related programs. Meyer said the budget assumes a 3% trend in the Medicaid estimate and includes roughly $12,000,000 in provider investments (with federal match) intended to reduce the need for a supplemental next year.

Meyer outlined several specific line items funded in the bill: a $3,000,000 increase for the elderly waiver to support Iowans living in community-based settings; rate adjustments for special nursing populations (including adults aging out of child services); and a $1,200,000 increase to support ambulatory surgery centers to preserve access for Medicaid members. The budget also moves prior increases for child protective services into the general fund and allows carryforward dollars to upgrade the child-welfare IT system.

The sponsor said the House accepted a number of the governor’s recommended reductions where stakeholder opposition was minimal, but rejected proposed cuts affecting child-vision screening, epilepsy services and mental-health transportation. Meyer also noted one-time funds were included to support the Department of Human Services’ application for an IMD (institutional mental disease) waiver, which the department would need to pursue to secure additional federal resources.

On behavioral health, the bill continues community health center funding under an existing mental-health grant for another year, requires an annual behavioral-health expenditure report by age group, and appropriates opioid-settlement funds for a detox and treatment facility. The package includes $9,300,000 in one-time funds and $1,500,000 ongoing for startup grants for medical-residency programs, which the sponsor described as part of a workforce strategy intended to expand access across the state.

The House recorded a roll-call on passage: 59 ayes, 24 no, and 17 absent or not voting. The chair declared the bill passed, the title was agreed to, and Representative Kaufman was instructed to message the bill to the Senate.

The chamber adjourned after the vote and will reconvene as scheduled.