SULLIVAN'S SALVOS

December 29, 2016

Sullivan’s Salvos 1/3/17

In this edition:

*Welcome to 2017!

*Welcome Kurt!

*Medicaid Managed Care

*Medicaid, Part 2

*Minimum Wage Reminder!

*Did You Know?

*Welcome to 2017!

Happy New Year! Here’s to a better and brighter year ahead! I have never been big on New Year’s resolutions – you can see that by my weight! But I certainly welcome the “fresh start” feel of the New Year. I hope 2017 is good to you and yours!

*Welcome Kurt!

Kurt Friese has joins the Board of Supervisors as of January 3^rd. A Democrat, Kurt was elected back in November along with Lisa Green Douglass and myself.

I look forward to working with Kurt. I didn’t know him particularly well until he started running for office, but I have learned that he is smart, thoughtful, articulate, and progressive. I look forward to working with him! Welcome aboard, Kurt!

*Medicaid Managed Care

I wrote the following in August of 2015. I wish I had been wrong!

Medicaid just celebrated its’ 50^th birthday. Medicaid and Medicare were among the greatest achievements in the history of our great nation. Health care for the poor… we have been called to provide this at least since Jesus walked the earth. The US finally got around to it in 1965.

Iowa will soon be embarking upon a system of “managed care” for folks enrolled in Iowa’s Medicaid program. I do NOT believe this will be a good thing for our poorest residents.

Managed care is a pretty simple notion. The idea is that healthcare is full of waste and fraud, and managed care companies will root that out. Without all this waste and fraud, the costs will go down.

The problem is, managed care companies rarely root out waste or fraud. They take an easier route. They simply cap services, and let the rest of the healthcare system sort it out. The managed care companies make their millions, and patients and providers fight over what is left. In my opinion, managed care is nothing more than a transfer of public tax dollars to private companies who are GUARANTEED to hurt the poor. Rather than being encouraged, managed care by private companies should be illegal. But that is not the environment in which we live.

Allow me to back up a moment. Medicaid (often referred to as Title 19) is the federal program that provides government health insurance to our poorest residents. Medicaid was passed in 1965 as an addition to the Social Security Act, a key component in President Lyndon Johnson’s “War on Poverty”.

While the vast majority of the funding for Medicaid is federal, each state pays a portion based upon the relative wealth of that state. Connecticut pays the most, Mississippi the least. Iowa is in the top half when it comes to relative wealth; in fact, our state match just went up because of the recent good years enjoyed by the ag industry.

Over time, states have argued for and received greater flexibility in designing state Medicaid programs. This is where the managed care concept began, and how it is spreading to states with Republican governors. In fairness, over the years, Medicaid has become a bigger and bigger piece of each state’s budget.

While many conservatives will try to tell you Medicaid has “not worked,” the reality is a very different story. In fact, 72 million Americans received some type of Medicaid service last year, almost 1 in 4. These services were provided at an average cost lower than private insurance, and at an average administrative cost MUCH lower than private insurance.

Will managed care improve things? No, it will not. Unless you own one of the firms that is about to suck millions of our tax dollars from our poorest residents. If you own one of those, you’ll be fine.

*Medicaid, Part 2

I used to work in the Iowa Medicaid program. Even though that was several years ago, I know Iowa Medicaid pretty well. That is why the Republican’s privatization scheme upsets me so much.

I understand who is on Medicaid. (About one in six Iowans; almost half of them children.) I also understand how poor they are. (To be eligible, an individual can only earn up to $11,491 per year.) And I understand how vulnerable they are. (Most nursing home residents are on Medicaid.)

Medicaid really, truly serves our most vulnerable citizens. Without this help, these people die. That is not made up. It is real.

Governor Branstad and Republicans in the Iowa Legislature have voted to give millions of our tax dollars to out of state corporations while poor Iowans get sicker and die. You may call that hyperbole, but I disagree. The fact is, when Medicaid is cut, poor people get sicker and die more quickly. It is proven. Any ignorance here is willful ignorance. They voted to hurt poor people. Period. What they voted for was evil.

Evil is a strong word. But what word would you use to describe someone who took away nursing home care from a sick elderly woman? What word would you use to describe someone who kept a sick baby from getting tubes in her ears? What word would you use to describe someone who left a poor man with an IQ of 40 on the street to eat from the trashcans? If you knowingly voted to make this happen? I call it evil.

This “experiment” is not working, just as experts warned. The Republicans in the Legislature not only put money ahead of people – they do that several times every day. But this time, they chose to pick on the weakest, poorest, least able to fight back. It is simply deplorable.

There is still time to fix this debacle. And fix it they should! The major cuts have not yet hit. The Managed Care Companies (MCOs) are begging for millions more; simply tell them no!

They may not get their just desserts electorally. They may go on to win many more elections. But I am convinced that someday they will be judged harshly. And I imagine it will be harsher than anything handed down by Iowa voters.

*Minimum Wage Reminder!

The third increase in Johnson County’s minimum wage took effect Sunday, January 1, 2017, taking it to $10.10 per hour.

Covered employers are required to pay the higher of the current federal minimum wage (29 U.S.C. Section 206), the current state minimum (Iowa Code Chapter 91D) or the Johnson County wage. Currently, the wage set forth in the Johnson County ordinance is the highest of those three, but this may not always be the case. Any employer subject to the requirements of the State minimum wage must follow the County minimum wage, unless the local city council has passed a counter ordinance.

The ordinance affects not only businesses that have a location in Johnson County, but also those whose employees perform work in Johnson County. Ordinances in individual municipalities may vary.

Employers and employees can learn more about the ordinance and its requirements at www.johnson-county.com/wage.

Questions about the ordinance may be directed to the Johnson County Board of Supervisors at 319-356-6000 or sups@co.johnson.ia.us.

*DID YOU KNOW? The largest group covered by Medicaid is children, which accounts for 43% of the enrollees. (Source: Health Care Finance Administration.)

Anyone interested in learning more about County government should take a look at the County website-

www.johnson-county.com.

"Sullivan’s Salvos" is sent once per week to any interested party. It will give a brief update on issues of interest to Johnson County residents.

These messages come solely from Rod Sullivan, and neither represents the viewpoints of the whole Board of Supervisors nor those of groups or individuals otherwise mentioned.

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As always, feel free to contact me at 354-7199 or rodsullivan@mchsi.com. I look forward to serving you!

---Rod

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SULLIVAN'S SALVOS

December 29, 2016

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