The Des Moines Register reported the disgraceful windfall for Iowa nursing homes, and questions whether political campaign contributions were the reason. Immediately after the 2016 legislative session ended, industry lobbyists alerted its members that it had succeeded in winning lawmakers’ approval of a new program that’s expected to generate a cash windfall for nursing homes at the expense of federal taxpayers. Assuming this legislation — which generated no public debate at the statehouse — is signed into law by the governor and approved by the federal government, nursing homes and hospitals in Iowa could collect an additional $206 million annually from Medicaid.
Through a complex ownership scheme in which the homes transfer their state license to a county hospital but maintain ownership and management control. The license transfer is designed to make it appear the homes are operated by hospitals. That’s desirable because Medicaid pays county hospitals and their affiliated nursing homes more than it does other nursing homes. Under this new “supplemental payment program,” the hospitals and homes would split the new Medicaid revenue, and the homes could use their share to pay for things like construction and renovation.
This scheme won’t have any impact on Iowa’s state budget because the hospitals will reimburse the state for its share of the Medicaid expense, while keeping the much larger portion of Medicaid money that comes from the feds. If that sounds like a scam, it’s because it is. While it’s true these contrivances don’t cost the state treasuries anything, they most definitely cost the taxpayers — in Iowa and elsewhere — a fortune in federal taxes. Why would Iowa politicians agree to the scam?
On one single day last October, the political action committee of Iowa’s nursing home industry made 83 campaign contributions to various statehouse candidates. Several weeks later, on a Wednesday morning in late December, this same PAC hosted a political fundraiser for Gov. Terry Branstad at the West Des Moines office of the Iowa Health Care Association. Forty-five checks, totaling $59,825, from nursing home executives and lobbyists were delivered to the Governor Branstad Committee that day. It was a very successful event, particularly since the governor wasn’t even running for office.
Rep. Dave Heaton, a Mount Pleasant Republican, floor-managed the bill. Asked why the program was approved with no virtually public debate, Heaton said the measure was backed by the Iowa Health Care Association — Heaton’s biggest campaign contributor — and no one spoke in opposition to it.
Each year, the average Iowan pays $9,485 in federal taxes. It’s flat-out irresponsible for legislators to green-light the transfer of hundreds of millions of dollars from Medicaid to the coffers of private industry without even inquiring as to the cost to taxpayers.
Letters to the Editor–Des Moines Register.
Another day, another giveaway to nursing homes and the health care industry in Iowa. Since Terry Branstad left his sinecure at Des Moines University to resume his role as governor, he has reduced staffing and oversight of crucial government functions, starting with the firing of Dean Lerner, head of the Department of Inspections and a thorn in the side of the state’s nursing home industry.
May 8 we read of the latest “big taxpayer giveaway” to Iowa’s health care industry by our executive and legislative branches, possibly as high as $206 million. This industry has been a significant contributor to the governor’s political campaigns and was the biggest contributor to the Republican representative who floor-managed the bill.
Coincidence or quid pro quo? You decide.
— Kathy Eckhouse, Des Moines
The fact that the governor accepts funding from the Iowa Nursing Home Association even when he is not up for election is amazing. Similarly for legislators such as Rep. David Heaton, who managed the floor bill for its “quiet” passage, without public notice or hearings, but received money from the Iowa Nursing Home Association. Heaton then said that the $206 million in federal expense was not their concern because it is not state money.
Well, Rep. Heaton, most Iowans pay federal taxes as well as state taxes, and the will of those who drafted Medicaid and Medicare laws did not intend that you use it for things like building renovation/construction. The intent of that revenue was to aid those who have the need for individual medical needs. One of those individuals was my son.
People in the disability community need to rise up and say “no more” to Branstad and those like Heaton in the Legislature. Hopefully someone will have the will to stand up for Iowans living with disabilities rather than playing “Iowa nice.” We do have organizations who are supposed to take a strong stand against these kinds of activity by elected officials. Who has the courage to stop these politicians?
— Sylvia Piper, Disability Advocacy Now, Ankeny