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Recent editorials published in Iowa newspapers

May 29, 2017

Burlington Hawk Eye, May 24, 2017

Setting an example

A little goes a long way, and the new Iowa law regarding fireworks goes too far.

Members of the Iowa Legislature can call the legalization of fireworks in Iowa a victory for freedom and fun all they want, but we’ll call it what it really is: a cynical effort to enrich state government and fireworks retailers.

For years, statehouse Republicans have been jealous of sales tax dollars raked in at cross-border fireworks stands, mostly in Missouri but also Wisconsin. So this year, with a firm grasp on power in Des Moines, the GOP did the bidding of the fireworks industry and repealed a generations-old prohibition against consumer use of fireworks in Iowa.

Iowa’s fireworks ban was enacted Jan. 1, 1938, almost seven years after a fireworks accident left downtown Spencer a smoking ruin (and a year after the same occurred in Remsen), and was intended to protect the safety of people and property.

Even though scofflaws would send up an occasional renegade Roman candle, detonate a rogue M80 or fill the air with the rebellious zipping and crackling sounds of bottle rockets, especially in the days before and after Independence Day, Iowans have lived in relative peace and quiet compared to those in states with fewer restrictions or none at all.

Alas, those days are at an end.

With outgoing Gov. Terry Branstad’s signature May 10, the ban was lifted immediately, opening the door to entrepreneurs to take advantage of the new commercial environment. Iowa Fireworks Co., based in Urbandale, has announced 18 store sites throughout the state, one of them at Westland Mall in West Burlington. And that’s just one company.

In an apparent nod to people who suffer the effects of PTSD, own nervous pets or those who simply enjoy peace and quiet, the unlicensed use of fireworks will be restricted to five weeks in June and July, and about four weeks in December and January. People can light fireworks only from their own property, or someone else’s with permission.

As they already do those things illegally, with no regard to the feelings or needs of others, we sympathize with those who see greater permissiveness as something other than good news. And we wish local police luck in enforcing the restrictions on newly legal fireworks use.

Yet while cities and counties are free to enact restrictions on use, proof the Legislature’s motives lie beyond fun and freedom for Iowans is the new law’s lack of any mechanism of local control at the retail end.

Proof that it is, in fact, all about the money.

The Legislative Services Agency estimated Iowa’s retail fireworks industry stands to rake in almost $18 million this year, and nearly $25 million next year. From that, state sales tax income is projected to be $1.1 million in 2017, and $1.5 million in 2018. Enforcement of the statute by the Iowa Fire Marshal’s office is expected to cost about 10 percent of that total.

In a city like Burlington, with older housing stock predating modern building codes for fire safety, we fear the more widespread use of fireworks — namely firecrackers, Roman candles and bottle rockets — will lead to more fires, demanding more of our already-stretched-thin municipal fire service, as well as driving up local home insurance rates.

With that in mind, we applaud the West Burlington City Council for considering an ordinance to prohibit the use of fireworks within 150 feet of an inhabited structure, a move that would make most of the city off-limits to fireworks at any time; and recommend it as an example for other Iowa cities and towns to follow.

Burlington City Council, this means you. And Mediapolis, Danville, Fort Madison, Keokuk, Mount Pleasant and all the rest, too.

Because we know where the retailers’ interest lies.

“They can ban the use but not the sales,” Iowa Fireworks Co. wrote Thursday in reply to a Facebook comment citing possible restrictions in West Burlington.

Show them the money, and the state of Iowa, too. The rest, apparently, just doesn’t matter.

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Telegraph Herald, May 26, 2017

Challenges await Gov. Reynolds

Wednesday was a noteworthy day in Iowa history. It was on May 24, 2017, that Terry Branstad concluded his record-setting tenure as governor and Kim Reynolds succeeded him, becoming the first woman to hold the office.

Someday, someone might top Branstad’s national record of more than 22 years (1983-99 and 2011-17) as a governor. However, barring George Clinton coming back from his 19th century grave to win election in New York, Branstad will retain his record for many years to come.

Branstad never lost an election. He won for the Iowa House twice, lieutenant governor once and governor six times. But that is not to say it was always smooth sailing. He constantly faced political opposition and criticism, occasionally from this editorial space. However, though they disagreed with him politically, few critics could fail to credit him for his work ethic, his public accessibility and his deep love for and commitment to Iowa.

We congratulate Branstad and wish him well as he embarks on what might well be the 70-year-old’s last stint of public service: U.S. ambassador to China.

When Reynolds ascended to the governorship — or, as the attorney general explained, had the duties of governor devolve onto her — it marked the day Iowa first had a woman governor. (Illinois and Wisconsin have yet to have that occurrence.)

She is prepared for the job. When Branstad picked her as his 2010 running mate, he committed to making her a full partner of his administration. That was a contrast from many states and many administrations (even in Iowa), where the lieutenant governor’s role seemed to be staying out of the governor’s way and certainly out of the limelight. (There were periods when those two officeholders came from opposing political parties, so lack of involvement was a given).

Now, after six years as Branstad’s understudy, the job is hers. In 2018, Iowa voters will decide whether the first woman to serve as Iowa governor will be the first woman elected governor. She is expected to seek election to the office in her own right.

Even with the Legislature adjourned until January, Reynolds’ “honeymoon” period will be brief. Ongoing and complicated challenges still face the state. From sagging state revenues, to Iowa’s sad state of water quality to failures in state oversight of child welfare, there is much on her plate — and not much time to address them.

It’s a historic accomplishment to be the first woman to serve as governor of Iowa. While she did not speak out much while her mentor was governor, now Gov. Kim Reynolds must chart her own course and strive to be the first woman to lead Iowa.

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Des Moines Register, May 25, 2017

Privatized Medicaid was supposed to save money?

Iowa is now 14 months into its experiment with privatized Medicaid management.

The stated rationale for moving away from state-managed Medicaid and into a system administered by private, profit-making companies was cost savings: The change was supposed to save taxpayers a fortune while also resulting in healthier Iowans.

Few people bought that argument, partly because some of the other states that had pinned their hopes on privatization had already experienced a rude awakening: Privatization was costing more and, at the same time, resulting in complaints of nonpayment from medical providers and patients.

And that’s where Iowa stands today. Privatization is a slow-motion train wreck, with providers across the state closing up shop or taking out loans to make payroll because the checks from Medicaid are slow to arrive and patient services are being paid at a lower rate. At the same time, the managed care organizations that Iowa hired to administer Medicaid say they are losing millions, and need an enormous increase in funding in order to make ends meet.

This was not only predictable, it was predicted. There was never any reason to suspect that a group of corporations, new to Iowa and burdened with all of the financial obligations associated with every for-profit endeavor, would somehow be able to serve the health needs of Iowans better and more efficiently than the state itself.

A new report from the nonpartisan Government Accountability Office illustrates one reason for this: Executive compensation.

The report examined the salaries and bonuses of top executives at Medicaid MCOs in 10 states — Iowa was not among the 10 — and compared them with the salaries of state-employed Medicaid directors.

The report shows that:

In 2015, Medicaid directors earned far less than most of the top executives at MCOs. The state-employed directors averaged $152,439 per year, while the total compensation for top MCO executives averaged $314,278.

Although the MCO executives were collecting far more pay than the state Medicaid directors, their work was easier. According to the GAO, MCO executives who once worked as state Medicaid directors said their duties at the state had been far more complex, time-consuming and demanding.

State Medicaid directors told the GAO that the federal government, the media, their governors and their state legislatures all held them personally accountable for the performance of their Medicaid programs. The MCO executives, who operate in comparative anonymity, told the GAO they were not generally accountable to lawmakers, the media or the public.

Just a few days after the GAO issued its report, two of Iowa’s MCOs reported another round of claimed losses in filings made with the Iowa Insurance Division.

According to these filings, AmeriHealth Caritas Iowa claimed losses of nearly $24 million in the first quarter of 2017, while Amerigroup Iowa posted a loss of $4.5 million. (The third MCO, UnitedHealthcare, has several lines of business in Iowa and does not file a separate set of financial reports for its Medicaid operation.)

The three MCOs are now in the process of renegotiating their capitation rates, which are the monthly, per-member fees the state pays the insurers to manage Medicaid.

The MCOs believe Iowa’s Medicaid program is “drastically underfunded,” and claim that during their first year of operation in Iowa, they each lost more than $100 million. In fact, AmeriHealth claimed losses of nearly $300 million and then informed providers of home- and community-based services it would no longer pay them the agreed-upon rates, but instead would pay them the absolute minimum Medicaid rate, regardless of the individual patients’ needs.

That’s a critical cost-cutting maneuver that will make it harder for providers to offer in-home caregiving for the elderly and the disabled. If these services, which include assistance with cooking and cleaning, are curtailed, more Iowans will be forced to leave their homes prematurely and move into costly care facilities where they’d rather not live.

Branstad bypassed the Iowa Legislature in privatizing Medicaid, and he did so with the blessing of the federal Centers for Medicare and Medicaid Services, but our state lawmakers aren’t powerless. They can intervene next year with legislation that prohibits the continued outsourcing of a fundamental function of state government — the provision of health care for Iowa’s most vulnerable citizens.

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Quad-City Times, May 26, 2017

Poor women will bear brunt of Planned Parenthood closure

Women in the Quad-Cities find themselves with significantly fewer options for health care, as Iowa’s GOP-run Legislature achieved its ultimate goal by shuttering the region’s Planned Parenthood clinic. And Iowa didn’t even try to fake it by rolling out some half-baked list of alleged alternatives.

The Bettendorf clinic was among four that will close in Iowa after the state banned spending Medicaid for any procedure there, Planned Parenthood of the Heartland announced late last week. The organization and its supporters were aghast. The pro-life movement rejoiced.

And, per usual, it is impoverished women who will pay more than their share of the bill.

Medicaid, mind you, provides health care for the poorest Iowans. It’s already foundering in Iowa since last year’s privatization. President Donald Trump has targeted Medicaid for deep cuts in his draft budget. Hospitals and physicians typically admit Medicaid recipients out of ethical duty or legal mandate. There’s little or no money to be made in serving Medicaid patients. In fact, patients with insurance often end up making up the difference, multiple studies have concluded.

Yet, it’s these patients to whom Planned Parenthood brought otherwise out-of-reach gynecological care. They’re a population with an abnormally high risk for sexually transmitted diseases. They’re less likely to receive regular gynecological exams. They’re at substantially greater risk for unwanted pregnancy.

Women across the socio-economic strata relied on Planned Parenthood. But, suddenly, those in the lower tiers are destined to have fewer options.

To these women, Iowa just said, “Tough.”

Medicaid — in Iowa or anywhere else — doesn’t pay for a single abortion, under federal law. No, the Legislature’s play here was to structurally hamstring Planned Parenthood while maintaining legal deniability in a constitutional challenge. And, of course, lawmakers hoped to score political points. They refused to back down no matter how many warnings they heard from physicians and social workers; partisan dogma superseded reason or constitutional right.

The timing was especially astounding, as the lawmakers spent this year’s session hacking and slashing to plug budgetary holes. Defunding Planned Parenthood will cost Iowa $3 million in federal funds this year. Another $3.3 million will be spent creating a state-run program to, feasibly, make up for the self-inflicted shortfall of women’s health care providers.

It’s that yet-to-be drafted list that’s at the heart of the matter. Four clinics across the state are closing. Many states that have tried similar attacks on a woman’s access to health care at least attempted to compile other options. Not in Iowa. Lawmakers just did it blind and directed the state Health Department to force reality into their partisan narrative somewhere down the line.

About 4,000 women have received treatment at Planned Parenthood in Bettendorf over the past three years, the organization’s officials say. Representatives with the national Planned Parenthood organization love to parrot statistics that abortions constitute just 3 percent of its procedures. Opponents counter that revenue from abortions make up more than 10 percent of the organization’s revenue.

Either way, the vast majority of care received by thousands of women in the Quad-Cities was dealing with women’s health outside of abortion. These women suddenly find themselves without access to their provider. They’re without the guarantee of a comforting, non-judgmental place in which to grapple with some of life’s most personal decisions. They’re victims of an anachronistic worldview that treats a woman’s body as something over which to lord.

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