Season 2 - Episode 23: HMO Conundrum

We might be a little upside down…but the issues aren’t.

In Episode 23 of Deciding Iowa, we break down a bill that:
➡️ Went from introduction to law in just 12 days
➡️ Raises taxes on HMOs
➡️ Could increase health insurance costs for Iowans

At one point, we realized our background was literally upside down… and honestly, it felt a little symbolic. 😅

Are we low budget? Yes.
Do we care deeply and do our homework? Also yes.

We’re here volunteering our time to make sense of fast-moving decisions that impact real people. Thanks for watching and listening.

🎥 Watch “HMO Conundrum” and decide for yourself.

Transcript

unknown 0:00

Okay.

SPEAKER_01 0:01

Hello, Bramer County, and welcome back to Deciding Iowa.

SPEAKER_00 0:04

I'm Dr. Sean Ellerbrook, and I'm a cancer scientist, biochem prof, and house district fifty-seven candidate.

SPEAKER_01 0:08

And I'm Doctor Emily Bavers. I'm a physician, mom of three, and a health advocate. So we're probably in the final stretch for the Iowa legislative season. Uh little relief there probably. As a reminder, the season started on January 12th.

SPEAKER_00 0:22

Yeah, the two finals, narrow, viable bills. However, some bills get moved to unfinished business where they can still be acted upon. Appropriations-related activities will continue until the legislation or legislature adjourns.

SPEAKER_01 0:37

Let's talk about a bill that we first discussed on March 16th, just a few days after it was introduced in the Senate. We mentioned that it could lead to increased health insurance premiums for Iowans, and it's now already been moved into law with incredible speed.

SPEAKER_00 0:53

You know, I feel like we're in the upside down. Last week, oh last week on March 25th, the governor already signed House File 2739 into law. That's right, the bill moved from introduction to Iowa law in just 12 days.

SPEAKER_01 1:08

So basically, this bill imposes additional taxes on health maintenance organizations in Iowa. Health maintenance organizations or HMOs are insurance programs that use basically a primary care provider and then a network of other providers to try to keep premiums and costs low by focusing on access to preventative care.

SPEAKER_00 1:31

Now, Iowa's privatized Medicaid system relies on these HMOs run by private insurance companies to provide care to those who don't have employer-based access or properly purchased plans. So it's it's it's fairly important to the health of Iowans.

SPEAKER_01 1:44

Exceedingly. And recently, the Medicaid Forecasting Group projected that Iowa's Medicaid system would have an enormous shortfall next year of$91 million, with larger deficits of$161 million to follow the year after.

SPEAKER_00 2:00

Just another budget shortfall because of mismanaged, short-sighted policy decisions.

SPEAKER_01 2:06

Agree. With house file 2739, the legislature voted to actually retroactively raise the tax rate from January of this year through September of this year, and then bring it back down in September.

SPEAKER_00 2:21

You know, and the companies themselves they they were they warned that this would increase the cost of insurance for Iowans.

SPEAKER_01 2:29

Absolutely it will. It makes sense. They're encountering an unexpected cost that is retroactively affecting the last couple of months, affecting this fiscal year. So yeah, they're gonna pass it on to consumers with who are the patients that need health care.

SPEAKER_00 2:44

You know, I know that Iowans cannot afford to spend more on health care or health insurance. Right. You know, expanded access to Medicaid is meant to reduce the number of uninsured who have no access to preventative health care.

SPEAKER_01 2:57

Yeah. You know, recently a national nonprofit, KFF, asked Americans whether they would continue to purchase their health insurance if premiums went up. Guess what they said?

SPEAKER_00 3:08

You know, 50% of people reported that if their premiums went up, they would just go without insurance.

SPEAKER_01 3:15

Not shocking, but more bad news for hospitals and clinics who exist to serve patients, but can only do that if reimburs reimbursement dollars are coming in to cover costs. I think that the legislature just introduced this bill on March 13th, then passed it 12 days later to basically try to look for a quick fix for these projected deficits.

SPEAKER_00 3:46

You know, they're they're scrambling to fix their mismanagement of state finances. Um more evidence of this uh lies in the fact that this bill also authorizes a transfer of$347 million from tax uh peer relief fund to cover Iowa's deficit.

SPEAKER_01 4:02

Yeah, more dollars flowing out of the surplus that the majority has been flouting.

SPEAKER_00 4:07

This is the kind of nonsense I'd expect from a teenager learning how to use a debit card.

SPEAKER_01 4:11

Pretty much.

SPEAKER_00 4:12

Not from our elected officials.

SPEAKER_01 4:14

You nailed it. Expect rocky roads ahead. But until next time, be well, Iowa.