By Brianne Pfannenstiel
An informal group of Republican and Democratic lawmakers met at the Capitol Wednesday to begin seeking solutions for mental health funding inequities across the state.
“Advocates were clamoring for more voice, more options,” said Rep. Kevin Koester, R-Ankeny and one of the task force leaders. “They really wanted a bipartisan approach.”
The task force is headed by members of each party from both the House and Senate as well as leaders from the advocacy group AMOS, A Mid-Iowa Organizing Strategy. At the top of the group’s agenda is addressing disparities in the way counties use property taxes to support mental health services in their region.
Iowa is divided into 14 regions that are required to offer a basic level of mental health services, ensuring that Iowans across the state have access to nearby care. Within each region, counties are tasked with collecting property taxes that go to collectively fund those services.
But the property tax rates were calculated and capped in 1996. Advocates and some lawmakers of both parties agree that the 20-year freeze has resulted in wide-ranging funding inequities that threaten to upend the regional system.
Polk County, which encompasses its own mental health region, has seen massive population growth in Ankeny and Waukee during the last 20 years. That region now is providing services for thousands more Iowans than the funding stream was originally intended for.
In other regions, like the one that includes Davenport, one county is driving the costs while others pay more in property taxes to subsidize those expenses. Still others have substantial cash reserves while others have been tapped out.
“I’m nervous that we might not keep all of our regions intact if we don’t make some adjustments,” said Koester.
But lawmakers who attended Wednesday’s meeting said they hoped to discuss other mental health funding issues across the state, including a workforce shortage for mental health professionals and a shortage of beds at mental health facilities.
Sen. Joe Bolkcom, D-Iowa City, said the state should be eminently concerned about the future of the Affordable Care Act, also known as Obamacare. As President-elect Donald Trump is set to take office with a Republican-controlled Congress, Republicans at the federal level have made repealing President Barack Obama’s signature piece of legislation one of their top priorities. But it remains unclear when they intend to repeal the law or how they would replace it.
About 132,000 Iowans have gained access to health insurance since the ACA was enacted in 2010, according to the U.S. Department of Health and Human Services, reducing the state’s overall uninsured rate by 46 percent.
Bolkcom warned that medical providers and county coffers have been bolstered by all of those Iowans who are newly insured under the program. Rather than seeking taxpayer-funded services through emergency rooms or other charity care, health insurance companies can help cover their costs.
“The cushion, the relief that has come to county budgets as a result of having (thousands of) new people with a payer for mental health and substance abuse services has created this huge reduction in the demand for county property taxes,” Bolkcom said. “And by God, if the ACA goes away without some sort of plan, the county taxpayers are going to be on the hook. People are going to look back at the counties and say, ‘Counties, regions, take care of these people.’”
And the state of Iowa — already tasked with trimming $110 million from the current year’s budget — also will face lean budgets in 2018 and 2019. Members of the task force all agreed on one thing: They should not count on new funding from the state to support whatever changes they recommend.
Republished from The Des Moines Register.