Barker

The second week of the Legislative Session brings more work on pieces of legislation. I was excited to have my first subcommittee on HSB 9, which is a bill regarding penalties for assaulting workers, volunteers, and students in health care. Subcommittees are a critical way that Iowans can provide input on legislation being considered. The bill passed subcommittee and will be eligible for debate in the Health and Human Services Committee.

Much of this week was spent learning more from the Department of Health & Human Services. I enjoyed having conversations with Director Garcia about how we can protect Iowa’s children and provide critical services to families in crisis. It was helpful to learn about the Department’s vision for early intervention services, foster care improvement, IT upgrades and Medicaid access. Additionally, we were presented the Governor’s proposal HHS budget this week. I look forwarding to continuing to learn more about these HHS issues.

In the Commerce Committee, we met with Commissioner Ommen of the Department of Insurance and Financial Services. His team presented to the committee about their work overseeing banks, credit unions and insurers in Iowa. We heard about challenges facing property and casualty insurance. I was also interested to learn about their work overseeing the pharmacy benefit manager middlemen. The Iowa Insurance Division has oversight of PBMs and there are 49 PBMs licensed in Iowa. During two years of regulation (Q4 2022 to Q3 2024), the PBMs 138,509 complaints with almost all of them being complaints related to reimbursement rates to pharmacies being lower than the pharmacy’s acquisition cost. Annual reports are due to IID by Feb. 15, which will provide more information on drug rebates. In addition, the IID is doing its own investigation into the trade practices of Iowa’s PBMs and will be providing details to the legislature on that investigation in the future.

Last week, the Governor laid out a number of priorities in her annual Condition of the State address. She said, “The well-being of working families and rural communities also depends on access to high-quality healthcare. While we have challenges, Iowa has a strong foundation to build on.”

• Iowa ranks:

• 1st – Lowest Healthcare Costs (WalletHub, 2024)

• 4th – Best Healthcare System (WalletHub, 2024)

• 9th – Healthcare Access (US News & World Report, 2024)

• 10th – Healthcare Quality & Prevention for Women (Commonwealth Fund, 2024)

• 11th – Best State to Have a Baby (WalletHub, 2024)

• 12th – Healthcare Outcomes (WalletHub, 2024)

• 14th – Women’s Health (Commonwealth Fund, 2024)

Like every state in the nation, Iowa is dealing with a shortage of doctors and healthcare staff, rising costs of care, and the need to ensure access to quality services in rural and underserved areas of our state.

Governor Reynolds has proposed:

• Investing $642,000 into newly unbundled Medicaid maternal rates.

• Working with CMS to implement a funding model to provide more Medicaid rate flexibility and incentivize creative regional partnerships.

• Consolidating and more than doubling funding for our student loan repayment programs.

• Establishing a Medicaid Graduate Medical Education enhanced payment to draw down over $150 million in federal dollars for more residency slots in Iowa’s 14 teaching hospitals.

• Streamlining the approval process for certificates of need to build new healthcare facilities or enhance current ones.

• Improving the Health Information Exchange network by authorizing HHS to competitively procure and manage it.

I love being able to meet with constituents from across this district. This week, I was able to meet with folks from our district about optometry services, tourism, veterans support and locally grown produce. One of the most impactful conversations this week was with the National Federation of the Blind about challenges accessing pharmacy services for visually impaired Iowans. I am looking forward to working with them on issues such as accessible pharmacy labeling to ensure all Iowans are able to safely access prescription drug information. Please let me know if you are coming to the Capitol so that I can make sure to visit with you. To reach me about concerns, please email brett.barker@legis.iowa.gov.