Des Moines Register. May 1, 2019
Why didn’t Sen. Grassley ask for federal Medicaid investigation?
Iowans should consider sending thank-you notes to U.S. Sen. Robert Casey. The Pennsylvania Democrat is doing what Iowa’s senators have failed to do: Request a federal investigation into privatized Medicaid health insurance.
Former Gov. Terry Branstad turned over Iowa’s program to for-profit companies three years ago. Despite life-threatening and costly problems, Gov. Kim Reynolds has refused to return control to the state.
Now a senator who doesn’t directly represent Iowans is getting involved. Casey requested an investigation by the U.S. Department of Health and Human Services (HHS). He cited media reports about for-profit insurers refusing to cover health care for vulnerable people and referenced a Des Moines Register investigation about care denials and endless appeals.
“Due to concerns that some MCOs are putting their bottom line ahead of patient health and safety, I am requesting that you open an investigation into this industry to shed light on whether all patients enrolled in Medicaid managed care can successfully access the services to which they are entitled,” wrote Casey.
Among the specific questions he wants the investigation to address: Have private insurers knowingly denied care that should have been covered? Are children, people with disabilities, older adults and others facing hurdles? What type of data should the federal government require states to collect to ensure patients are not inappropriately denied care?
The HHS Office of Inspector General agreed to conduct an investigation, and findings are expected in 2020. The federal agency, which largely funds Medicaid for more than 70 million Americans, certainly should be interested in this issue.
So are Iowans.
Also noteworthy is Casey’s mention of a subsidiary of the health insurer Centene, which Iowa recently contracted with after the abrupt departure of another Medicaid insurer.
Centene denied round-the-clock nursing care to a child who needed a tracheotomy tube to help him breathe. The toddler needed continual supervision to prevent him from removing the tube. After the insurer refused to pay, the boy pulled it out, was deprived of oxygen and was left with limited brain function.
Let’s hope such reprehensible care denials are not on the horizon for Iowa children.
Casey’s request for an investigation raises an obvious question: Why didn’t Iowa’s members of Congress make it?
Sen. Chuck Grassley regularly expresses interest in potential Medicaid misspending and he hasn’t been shy about investigating misuses of public money.
He must know hundreds of millions of Iowa’s Medicaid dollars are being funneled to for-profit companies for “administration” instead of paying for Iowans’ health care.
He must have heard at least some of the many complaints from Iowa patients, doctors, and hospitals.
His staff, which closely follows news in Iowa, must know per-patient costs have tripled under privatization.
A Register editorial writer asked Grassley’s office for a comment from the senator.
“It’s always worthwhile to conduct an independent review to make sure taxpayer dollars are being well-spent and government programs are achieving their intended effect,” said Grassley. He expressed support for Reynolds and hopes a review can help inform policymakers on ways to improve Medicaid “even further.”
There is no evidence Medicaid has been improved at all by privatization. Just the opposite.
It will, however, be interesting to see what, if anything, Grassley has to say if the inspector general finds problems. For three years, he has largely ignored the hurtful impact of privatization in Iowa.
Fortunately, a senator from Pennsylvania didn’t.
______
Quad City Times. May 2, 2019.
A cruel month
How many times over the flood-soaked years have we heard it - the idea that flooding in Davenport isn’t the fast-moving catastrophe you see in the movies?
Instead, it’s typically been a slow-moving disaster; water insidiously creeps into our downtown and stays as long as it wants.
Except on Tuesday, it wasn’t that at all.
When a flood barrier gave way at River Drive and Pershing Avenue, the Mississippi River surged. It didn’t creep or seep. It did not go gently onto 2nd Street. It moved swiftly and with strength.
Kathleen Vondran watched from her office at the intersection of 2nd and Pershing.
“It was like this little wall that kept growing and growing. It was incredible,” she said.
It was incredible. A street that had been passable just hours before now was soused. Cars and trucks bobbed, as if in a bathtub.
People who had parked on those same streets and gone home, such as to the Petersen Paper Company Lofts, had to be removed by rescue boats.
This isn’t what’s supposed to happen in Davenport. Our floods usually give plenty of warning. It’s what we count on.
Not this time. Which begs the question, which barriers might go next?
Perish the thought. The City of Davenport said the HESCOs were holding.
On Tuesday night, we looked for ourselves. Standing south of 2nd and Main streets, outside the Figge Art Museum, there they were - solid, comforting and, for the moment, doing their job.
Common in war zones, these barriers were now standing guard for us, pushing back against an unimaginable amount of pressure bearing down on them from America’s biggest river.
Perhaps we should not linger on that thought for too long.
As we write this, we hear that barriers gave way in Buffalo. We try not to imagine the worst.
For 40 days, this flood has insisted upon us. It passed being tiresome weeks ago.
It seemed as if we’d turned the corner when the water began to recede last month, when the mud and the grunge of the river was visible; when the idea of cleanup was on the horizon.
Even the muck was a more welcome sight than the whitecaps we were seeing on windy days.
Now, here we are again.
In Davenport, flooding is something we cope with. We know its routines and its habits. It moves slowly, insistently, without invitation. But it generally doesn’t take too long to go away.
But, again, not this time. This year’s flooding has been with us 40 days, a record. The water is in no hurry to go home.
On Tuesday, the river told us it could do exactly what it wished. It could do more than just seep onto our streets and into our spaces. It could gush forward and beat our barriers and heretofore-successful flood plans.
The worst part is, we are told the water will be with us for a while yet. This latest crest (again, the second one) is a midpoint of sorts. Now, the water has to recede.
It will. Slowly. As slowly as it arrived. A pity it can’t gush back into the river, as it did into downtown Tuesday afternoon.
April may be the cruelest month. May looks to be the longest.
____
The (Fort Dodge) Messenger. May 6, 2019
Reynolds’ agenda moves forward
In January, Gov. Kim Reynolds set out an ambitious agenda for Iowa lawmakers. With the 2019 legislative session now over, the governor can look back on what was accomplished with a good deal of satisfaction. Not everything she advocated was approved but major progress in moving toward the goals she outlined in her Condition of the State Address was achieved.
“The biggest winners of this legislative session were Iowa students, families, farmers, small business owners and our rural communities,” Reynolds said in a statement issued just after the Legislature adjourned. “We made historic investments into pre-K-12 Education and put more money into community colleges and our public universities. We protected job creators who hire individuals with past criminal offenses and funded the Future Ready Iowa Initiative, so that Iowans can get the skills they need for cutting-edge careers.”
Among the most important actions by the Legislature were increased funding for pre-kindergarten through 12th grade education and the creation of a first-of-its-kind Children’s Mental Health System for the state. Additionally, the Governor’s Empower Rural Iowa Initiative, which got the Legislature’s approval, will help make sure that no part of the Hawkeye State is left behind as we ready our state for continued success in the 21st century.
Reynolds asked the Legislature to begin the process of amending the state’s constitution to make essentially automatic the restitution of voting rights to felons once they had completed their sentences. Even though this action had strong support among lawmakers it failed to achieve approval this year. We applaud the governor’s commitment to keep this proposal moving forward when the Legislature reconvenes in January.
We commend the governor and members of the Legislature for continuing to keep the state’s finances in good order. Frugal management of the monies provided by Iowa’s taxpayers long has been a priority of the Republican Party. Reynolds and the GOP majorities in both houses of the Legislature are keeping faith with that important goal.
Looking to the future, the governor has an innovative vision for Iowa.
“We will also continue our focus on growing the economy as well as create opportunities to attract top talent to Iowa by sharing our story as a vibrant, affordable and welcoming state,” Reynolds said.
The Messenger thanks the governor for her superb leadership and dedication to keeping Iowa a wonderful place to call home and a state with an exceptionally bright future.
____
Dubuque Telegraph Herald. May 5, 2019
Debt and deficit problem traces to U.S. voters
Apply a coat of paint directly on your vehicle’s rust spot, and what happens? It looks better. For a while. If you don’t do the hard work - sanding, priming and the like - the rust soon eats through the paint and the unsightly spot returns with a vengeance.
The paint and rust analogy applies to recent and ongoing reports out of Washington reflecting the short- and long-term health of the U.S. government and economy. The reverberations reach us here in the tri-state area.
With only an occasional blip, the U.S. economy has been on a winning streak. On Friday, we learned that employers added more than a quarter-million jobs just in April. That report, continued low interest rates, low unemployment and other positive indicators tend to ease concerns about an economic slowdown being imminent.
That’s all good news. But in many respects, they are like the aforementioned paint.
Politicians, particularly those with Twitter accounts, exhort Americans to focus on those positive reports - and only those reports. The newly painted surfaces. The shiny objects. They know it’s easier to win votes by pointing to what’s attractive than by discussing - not to mention solving - difficult and painful decisions. The rust.
But the rust is there.
For decades, warning flags have been raised about federal debt, budget deficits and endangered entitlement programs. Politicians tend to offer assurances that those problems are distant, overstated or something that will miraculously solve themselves through economic upturns.
And so they kick the proverbial can down the road.
Increasingly, however, the end of the road is coming into view.
The Congressional Budget Office, which doesn’t have to placate voters or stand for election, last week updated its budget and economic forecasts for the next decade. The numbers are not pretty. The agency predicts that the federal budget deficit - overspending - will hit $896 billion this year and top $1 trillion annually as soon as 2022. And that could be a best-case scenario. The projections assume no changes in laws, no recession and temporary tax cuts not being made permanent.
“How many more dire warnings will it take before our leaders address the nation’s dismal fiscal picture? Rather than addressing the rapid growth of health and retirement costs, the last Congress cut taxes and increased spending by a combined $2.4 trillion,” stated Maya MacGuineas, president of the Committee for a Responsible Federal Budget. “Now we’re talking about $2 trillion more of spending, and as much as $2 trillion on top of that for infrastructure, with virtually no word of how we will pay for them. At some point, the fiscal recklessness has to stop.”
Indeed. If the staggering numbers of the growing federal debt can’t command enough of the public’s attention, perhaps the prospects of the Social Security program going under will.
In their recently released annual report, Social Security trustees warned that, without major changes, Social Security will be insolvent in just 16 years. The ongoing funding imbalance - more money going out to beneficiaries than is coming in from U.S. workers - is going to get worse. Without serious decisions - none of them will be popular - the impacts will include reduced benefits and higher taxes.
Elected officials past and present, Republican and Democrat, deserve plenty of blame for this situation, but so do voters.
After all, politicians are fully aware of voters’ longstanding aversion to tough decisions - tax increases, benefit cuts and the like - when those decisions adversely impact voters. How else do you explain voters thanking politicians for tax cuts when those cuts are adding to the IOU that must be covered by our children, grandchildren and great-grandchildren?
The sooner voters come to the realization and acceptance that they, too, must pay a price for the debt and deficit spending, the sooner they will elect politicians with the courage to make the tough and unpopular decisions that are nonetheless necessary for our country in the long term.
We can’t continue to paint over this problem. It’s going to take sandpaper, elbow grease and primer before real solutions will stick.
Please read our comment policy before commenting.