‘A bad idea all around’

Anne Discher

The Iowa Fiscal Partnership released the following statement today from Anne Discher, executive director of the Child and Family Policy Center, about federal guidance to states on Medicaid.

“Iowans served by Medicaid face enough challenges in our state without this additional level of uncertainty from the Trump administration.

“Already, changes in Iowa’s Medicaid program have caused a loss or reduction of health-care services to struggling families, and at a time of fresh proposals in the Legislature to further restrict access to care, the news from Washington is not good.

“The new administrative guidance for Medicaid issued by the Centers for Medicare and Medicaid Services rips away the guarantee of coverage for adults and parents. It takes away family security by letting states choose who gets coverage and what kind of coverage.

“We have seen in Iowa what happens when states change the rules of the game on a whim. All Americans need federal guidelines that assure an expectation of care, and a transparent process so residents understand what’s at risk. 

“No matter what you call it — and you’re likely to hear phrases like ‘block grants’ or ‘per capita caps’ — it equals less less federal funding for Iowa and fewer insured Iowans.

“It does nothing to address the real health crises we face, including inadequate mental health services and the decline of obstetric care in rural Iowa. And it could threaten the state’s ability to effectively respond in times of need like during an economic downturn, an epidemic like coronavirus, or a natural disaster. 

“It’s also worth noting that legal experts raise serious questions about this proposal. It will likely result in costly litigation while trying to make it harder for low-income Americans to have affordable health insurance.

“This plan is a bad idea all around for our state.”

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The Iowa Fiscal Partnership is a joint public policy analysis initiative of two nonpartisan, nonprofit, Iowa-based organizations — the Iowa Policy Project in Iowa City, and the Child and Family Policy Center in Des Moines. Find reports at, and the IPP and CFPC websites, and


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