SULLIVAN'S SALVOS
June 10, 2025
Sullivan’s Salvos 6/12/25
In this edition:
*LA ICE Protests
*Father’s Day
*Juneteenth
*Pride Flag
*Antisemitism
*Medicaid Crisis
*Did You Know?
*LA ICE Protests
Praying for everyone involved in the ICE riots in LA. We have a truly evil President – the next three years are going to be very hard. I just hope protesters will stay nonviolent. Again, praying for all of us!
And do not forget – as serious as things are in LA, it is all a distraction. Donald Trump wants you to forget about Medicaid cuts. Do not let that happen!
*Father’s Day
Father’s Day is June 15. Happy Father’s Day to all the dads out there! I know both Mother’s and Father’s Days can be very difficult for some people, for a variety of reasons. If that is you, you are in my thoughts.
Being a dad is the best thing I have ever done. It is also the most difficult. I imagine that is the case for most fathers. And sometimes, we are not birth fathers; we are just folks trying to help the best we know how.
It has been decades now since I have had the pleasure of enjoying a living father or grandfather. If you are lucky enough to have a father or grandfather around, please take a moment to reach out to him this weekend.
*Juneteenth
Johnson County is working with a number of community partners to present Juneteenth activities! There are several events, all listed on the webpage.
For more info, visit the Facebook page at: https://www.facebook.com/jciajuneteenth.
By the way, in 2021, The Johnson County Board of Supervisors voted unanimously to make Juneteenth a paid holiday for union and non-union employees. The decision followed President Joe Biden declaring Juneteenth a federal holiday for the first time a few years ago and many other Iowa cities doing the same.
One difference? Most cities and counties took away a different holiday in order to acknowledge Juneteenth. Many, for example, swapped it out for President’s Day. Johnson County simply added a new holiday. I am proud of that.
*Pride Flag
Johnson County is once again flying our Pride Flag outside the Admin Building. I have found it interesting to see that there is some online buzz around this – after all, we have been flying that flag every June for 16 years! But I’m glad folks are paying attention, and I’m glad it is serving as a rallying point. Happy Pride!
*Antisemitism
The number of attacks on Jews in America has skyrocketed recently. We have seen huge throngs chanting, “Jews will not replace us.” Antisemitism is on the rise, and it must stop!
This sickening situation is made even worse by two things:
1. Some blame attacks on US Jews as retaliation against the Israeli government. First, violence is never an appropriate response. Second, the horrible Likud government in Israel has nothing to do with attacks on American Jews. Most Jews (especially in the US) do not support Likud.
2. The Trump Administration uses the idea of antisemitism to attack science, higher ed, and more while actually being the most antisemitic US administration since James Buchanan. To do so disingenuously in the name of Jews only adds insult to injury.
To my Jewish friends: I see you. I’m sorry. I have your back.
*Medicaid Crisis
(This ran in Salvos one year ago. Unfortunately, it is still very timely.)
You may get tired of me mentioning another crisis, but I wanted to update everyone on yet another huge problem in Iowa – low Medicaid rates. I used to work with the Iowa Medicaid program when I worked for DHS. I learned a lot about who gets Medicaid and why. More importantly, I learned how many things could be improved.
Some background: Medicaid is a program of the Great Society efforts the Johnson Administration passed in the 1960s. This was absolutely groundbreaking legislation! Prior to FDR in the 1930s, the US had a system of County poor farms. That was it. Many Americans starved to death, and few lived to old age. The English philosopher Thomas Hobbes had a famous quote that fit the situation perfectly. He argued in his book Leviathan that, without government, life would be “solitary, poor, nasty, brutish, and short.” Hobbes was right. And FDR did a lot to help improve that situation. FDR addressed this primarily through ending child labor and the creation of Social Security.
FDR had proposed a system of national healthcare several times, but it never had the votes. Meanwhile, the poor in America, while certainly much better off than before, were dying from easily treatable medical conditions. Finally, in 1965, Medicaid and Medicare passed the US Congress. But it was never easy. Conservatives opposed their creation, and have fought to weaken, undermine, and diminish these programs since the day they passed.
Medicaid provides health insurance coverage to poor people across the US. These poor people include many disparate groups. Most are senior citizens living in care facilities. Medicaid is the top payor of this service. Others covered include poor children, foster children, people with disabilities, and in many states, the working poor. Medicaid eligibility is always income dependent, so recipients must meet income and resource guidelines.
Medicaid is primarily a federal program, but with a smaller state match. Over the years, states have been given greater and greater flexibility in terms of designing and administering Medicaid. This has led to several good innovations, but has more often led to conservative states diminishing this benefit for their poorest residents.
In Iowa today over 1 in 4 residents receives Medicaid. One in four! But Iowa has a created a HUGE problem with its Medicaid program – unsustainably low rates.
What does that mean? Medicaid has set rates for every available service. If you need an appendectomy, there is a set rate. If you need nursing home care, there is a set rate. If you need a ride in an ambulance, there is a set rate. These rates rarely cover the cost of the service provided; that is a problem nationwide. But in Iowa, the problem is at a crisis level, and getting worse. Rates in Iowa are SO low that services are at risk.
For example, Iowa underfunds fund group home settings for folks with intellectual disabilities. (Locally you may be familiar with Systems Unlimited or Reach for Your Potential; there are others.) These organizations do incredible work caring for our most vulnerable residents. And Iowa is making it impossible. Medicaid rates are so low that these agencies cannot even figure out how to pay minimum wage. It is a crisis.
Another example: Iowa is almost devoid of substance misuse providers. (Locally you may remember MECCA, later known as Prelude, then acquired by CFR.) There are only a few counties in Iowa where you can get treatment for substance misuse. Agencies have simply closed, and more are closing. Medicaid rates are so low that these agencies cannot keep the doors open. It is a crisis.
One more example: I recently sat in on a meeting of folks trying to get dental appointments for poor kids. Almost ZERO dentists in Iowa accept Medicaid. Literally almost ZERO! It is a money loser, and dentists are not required to take it. So they don’t. Meanwhile, thousands of children from all 99 of Iowa’s counties flock to the UI to be treated at the College of Dentistry. Waiting lists are so long that the associated health problems become serious. The kids are seen in emergency rooms. They suffer lifelong serious consequences because they couldn’t see a dentist as a kid. Meanwhile, the dentists you know make a lot of money. It is a crisis.
Those are just three examples. There are likely 3000. The government of the State of Iowa is quite simply underinvesting in the Medicaid program. Which means we are failing our most vulnerable residents.
What can be done? It’s really quite simple – Iowa could raise the Medicaid rates for these and other services. We have the money – Iowa is sitting on a lot of money! Iowa ended Fiscal Year 2023 with a $1.83 billion surplus in the general fund, in addition to $2.74 billion in the state's Taxpayer Relief Fund and $902 million in reserve funds, according to the March Revenue Estimating Conference. (Note: Iowa received about $6 billion from the federal government as part of various federal relief programs.)
So yes, we have the ability to greatly improve these situations. We can do it, we should do it, and I believe we must do it. But don’t hold your breath! This Governor has sat idly by and watched poor Iowans die on a number of occasions – Medicaid Managed Care, COVID, etc. She will do it again. Our poorest residents are dying. She refuses to help. She’s got to go.
*DID YOU KNOW? State Medicaid matches are based upon each state’s relative wealth. Connecticut (1) has the highest state match, while Mississippi (50) has the lowest. Iowa’s match is 35% - ranking us 31st. Not at the bottom, but poor. (When I worked there in the 90s, Iowa was 24th. We have fallen.)
Anyone interested in learning more about County government should take a look at the County website-
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---Rod
posted by Rod Sullivan @ 8:37 AM
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