The Iowa Department of Human Services has concluded contract negotiations with the private companies contracted to manage Medicaid in the state.

But the agreed-upon spending increase of $386 million for the two managed-care organizations — tantamount to an 8.6% raise — has some Democratic lawmakers scratching their heads.

“The amount is jaw-dropping,” said Iowa Sen. Pam Jochum, D-Dubuque, who sits on the Senate Human Resources Committee. “When it was a public system, we never approved that high of a raise.”

The private managed-care organizations took over the state-run Medicaid program, which provides health care to about 600,000 needy and disabled Iowans, in 2016. Since then, the system has been lambasted by patients, providers and lawmakers who claim the system is inefficient, costly and hurtful to patients.

Iowa Rep. Shannon Lundgren, R-Peosta, chairs the House Human Resources Committee. She said in an emailed statement that much of the increase came from money already appropriated in the Health and Human Services budget for fiscal year 2020, which began July 1.

That funding covers adult mental health reforms, nursing facility and rural hospital reimbursement rates and more. Federal increases also are accounted for in the increase, Lundgren wrote, as well as a bolstering of Hepatitis C treatment.

“When you subtract out all these legislated and program/policy changes above, the actual rate increase to the MCOs is 3.95% ($189.5 million total, $61 million state increase),” she wrote.

Lundgren also claimed that some of the increase was due to the state having to pay additional funds because former MCO UnitedHealthcare left Iowa’s system. Those, she wrote, were one-time funds.

Jochum, though, said she wasn’t buying it — except as a taxpayer. She said that in her experience, Iowans are paying more for less.

“Especially people with pre-existing conditions or disabilities,” Jochum said. “They now have case managers who are not independent or conflict-free. It is the case managers who work with the patient. They are who you ask, ‘What services do I need over the next year to improve my social skills, my work skills? What do I need if I have multiple disabilities?’ The answer to any of those is just ‘No’ or there isn’t one. Locally, we still are not doing well.”

Lundgren said the new contract also includes new, stricter oversight guidelines for the remaining MCOs.


U.S. Sen. Joni Ernst, R-Iowa, reported raising more than $1 million more for her re-election bid for the November 2020 election, bringing her cash-on-hand to $3.4 million.

Her campaign has boasted that the total raised is more than any Iowa candidate for national office in recent history.

Ernst will face the winner of a Democratic primary between at least three candidates — Kimberly Graham, Theresa Greenfield and Eddie Mauro.


A federal court judge has blocked an administrative move from President Donald Trump that would require pharmaceutical companies to reveal the price of their drugs in ads on TV.

That angered area U.S. Sens. Chuck Grassley, R-Iowa, and Dick Durbin, D-Ill., who have long fought for transparency in drug pricing.

“The ever-rising cost of prescription drugs is one of the most pressing problems in our health care system,” Grassley said in a release from the two senators. “Targeted, bipartisan solutions will provide real relief to patients and health care consumers. The direct-to-consumer price disclosure measure is a common-sense approach that will help reduce drug costs. There is a severe lack of transparency in the health care system. The DTC measure would shine a light on the outrageous cost of medications and give health care consumers information they need to make the best decision for their circumstance.”


U.S. Rep. Abby Finkenauer, D-Iowa, introduced a bill this week that would allow students “scammed by predatory colleges” to seek federal student loan relief.

The Relief for Defrauded Students Act of 2019 targets private colleges which charged students for classes or degrees and either went bankrupt before those degrees could be completed or made other changes to not give students what they paid for.

Finkenauer visited Cedar Rapids on Monday, where she was joined by two students who suffered financial losses when they took classes at that city’s campus of ITT Tech, a now defunct institution with sites in many states.

A release from Finkenauer claimed the students were left both with debt and a lack of the skills they paid to acquire.


  • 4 p.m. today, Smokestack, 62 E. Seventh St. — Presidential candidate and U.S. Sen. Michael Bennet, D-Colo., will hold a meet-and-greet event.
  • 7 p.m. today, Smokestack — Presidential candidate and U.S. Sen. Kirsten Gillibrand, D-N.Y., will meet caucus-goers in Dubuque.
  • 3:30 to 4:30 p.m. Monday, July 15, Timber Lanes, 1005 E Platt St., Maquoketa, Iowa — Gillibrand will hold a meet-and-greet event.
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