2024 Session: Week 13

Medicaid Coverage 12 Months Postpartum Passed

On Wednesday the House passed SF 2251 in a 70-25 vote. SF 2251 will extend postpartum Medicaid coverage from 60 days to 12 months for women at or below 215% of the Federal Poverty Line (FPL). The reduction of the FPL for eligibility from the current 375% for pregnant women down to 215% was a significant sticking point throughout negotiations, with IMS and many members of the multi-year postpartum Medicaid coverage coalition of stakeholders working in favor of a rate at or closer to the existing 375%.

While the bill is not exactly as we would optimally prefer, it does mark a momentous occasion by extending coverage to Iowa’s most vulnerable women and mothers. And it is in no way the end of the discussion for advancing maternal health care and coverage. IMS and our coalition partners have already engaged in positive conversations with leaders about the legislative and non-legislative options to ensure that all pregnant women have a pathway to coverage and that infants receive the same standard of care whether through HAWK-I or more traditional Medicaid coverage.

The bill will now head to the governor’s desk for signature. We anticipate Governor Reynolds will sign the legislation into law within the next two weeks, with the provisions taking effect January 1, 2025.

Eyes on the Budget - Prioritizing Rural Loan Repayment Programs(s)

As we enter the final weeks, legislative attentions are focusing in on the budget. Initial drafts of department budgets have been introduced and formal negotiations are beginning. One budget area of particular interest is the funding allocation for the Iowa Rural Primary Care Loan Repayment Program. Initial proposals within the Department of Education appropriations bill (SSB 3201) have the program funding maintained at $2.5 million.

In a year when state budgeteers are also working to craft budgets in consideration of the proposed lowering of income tax rates, appropriations advocacy comes in two parts: First, ensure there is no reduction in funding as part of any cost-cutting measures. Second, seek additional funds to fully support the program as intended. With part one of the fundraising strategy secured, the negotiations to increase dollars begin.

Initial conversations have been positive, building off of legislative priorities throughout the session surrounding workforce development – specifically maternal and mental health shortages – and the particular interest taken by legislators from conversations with student physicians during Physician Day on the Hill. Stay alert for action alerts to come as we work with appropriations committee members to add $1.5 million to fully fund the loan repayment program.

Status Updates for Key Healthcare Bills

Bill Number	Bill Title	Position	Status
SF 2251/ HF 2583	Eligibility for pregnant women and infants under the Medicaid program (Extension of coverage 12 mos postpartum)	For	Passed the House; Moves to the governor for signature
HF 2673 / SF 2420 /	Relating to the transition of behavioral health services from mental health and disability services system to a behavioral health service system (Behavioral health system redesign)	Undecided	Passed the House 04/02; On to the Senate
HSB 743	Relating to reimbursement of providers by Medicaid managed care organizations for items and services subject to prior authorization	For	Passed House Ways & Means; subcommittee; moves to full committee
SF 2395	Relating to the opioid settlement fund, including appropriation of moneys in the fund	Undecided	Passed House Approps sub with amendment
HF 2668 / SF 2159	Insurance coverage for biomarker testing (includes Medicaid and HAWK-I)	Undecided	New clinical utility language agreed upon; House and Senate files attached
SF 477	Licensure of internationally trained physicians (Provides streamlined provisional license)	For	Awaiting the governor’s signature
HF 2488*	Relating to prior authorization and exemptions by health benefit plans and utilization review organizations (“Gold carding” pilot program) *passed with amendment that will require removal for continued IMS support	For	Passed the Senate; back to the House
SF 506	Relating to health facilities and health services, including licensing and the certificate of need process (Increased spending thresholds and elimination of CON for community mental health & birthing centers)	Undecided	No movement this week
HF 2565	Relating to provision of Medicaid coverage and services to certain inmates under the Medicaid program. (1115 waiver)	For	No movement this week

Advocacy Action of the Week

Check out the legislative forums being held by legislators across the state! These local, public meetings are a great chance to connect with your legislator outside of the Statehouse – these in-person connections are what solidify relationships – and influence! - beyond the email or the single day interactions at Physician Day on the Hill.

The events happen not just during session, but also continue through the interim. Check out the current list of scheduled events, compiled by our friends at Brown Winnick.

Events