Gov. Kim Reynolds’ bill that aims to improve access to health care across the state cleared its first hurdle in the Iowa Legislature Wednesday with bipartisan support.
A day before that, Reynolds presented her plan at a news conference. She said Iowa, like every other state, has a shortage of health care providers.
“We have a ways to go, but we’re committed to turning it around and making sure that Iowans have access to high quality health care no matter where they live in the state of Iowa, and that is the collective goal,” she said Tuesday.
Reynolds is asking the Legislature to eliminate several separate loan forgiveness programs for different health professionals and consolidate them into one $10 million financial incentive program, which is more than twice the current funding.
Her bill would have state health officials seek federal permission for Medicaid funding flexibility to expand the Centers of Excellence program that is geared toward improving health care access in rural areas. Reynolds said that would allow for a “hub-and-spoke model” with larger providers in a region offering a wider range of services while keeping close connections with providers in surrounding areas.
"We have a ways to go, but we’re committed to turning it around and making sure that Iowans have access to high quality health care no matter where they live in the state of Iowa."Gov. Kim Reynolds
There are currently five such centers in the state.
Kevin DeRonde, CEO of Mahaska Health in Oskaloosa, said the Centers of Excellence program has led to a major increase in births at his hospital, as well as the opening of southeast Iowa’s first-ever fertility clinic. He said the program has also led to expanded care for people with cancer and heart conditions.
“This initiative expands access to high quality, specialized health care while keeping primary care local, strengthening regional partnerships in maternal health and obstetrics, surgery, oncology and cardiology,” DeRonde said.
Reynolds has also directed the Iowa Department of Health and Human Services to seek federal funding to create more than 115 new medical residency positions per year across the state’s 14 teaching hospitals. She said she feels “pretty confident” the state can get federal money to train more doctors, even with cost cutting led by the White House Department of Government Efficiency.
In addition to these broader health care efforts, Reynolds is proposing ending Iowa’s policy of paying hospitals and doctors the same rate for Medicaid-covered births regardless of the complexity of the patient’s pregnancy. She wants to “unbundle” Medicaid maternal rates and boost that funding by about $640,000, with $420,000 of that going toward complex pregnancies.
House subcommittee advances Reynolds’ bill
Health care lobbyists praised Reynolds’ bill during a subcommittee hearing Wednesday.
Seth Brown with the Iowa Medical Society, which represents physicians, said Reynolds’ focus on expanding loan repayment programs and medical residencies will move the needle on getting more doctors to Iowa.
“Because ultimately, where they train is where they decide to work and live most of the time,” he said. “And also providing a competitive recruitment incentive through loan repayment programs is a very meaningful way to get physicians to the state.”
Amy Campbell, a lobbyist for several health care organizations, said health providers like that the bill would allow for loan repayments and direct payments, and for changing which providers can get those incentives.
“I just think that the flexibility gives us that opportunity to move and change the programs as needed,” she said
Campbell also urged state officials to be transparent as they make decisions about how to use those financial incentives.
All three members of the House subcommittee voted to advance the bill.
“I think that we are hopefully finally going to really start making a dent in our shortage of health care workers,” said Rep. Timi Brown-Powers, D-Waterloo.
Rep. Ann Meyer, R-Fort Dodge, said she wants to see the bill advance through the full House Health and Human Services Committee.
“I am also very excited about the impact this is going to make on the physician workforce,” she said.
