We picked mismanagement



Gov. Terry Branstad promised in 2015 that turning over Medicaid to private insurance companies to manage would save taxpayers $400 million per year. Since then, the program has cost an additional $600 million or so. The state recently announced that it would increase payments to the two companies remaining in the program by $386 million, or nearly 9%.

Gov. Kim Reynolds said that should be enough, now that we have three solid years of history to work with.

Enough to know that it was a calamitous mistake that leaves the state with at least a $100 million annual budget deficit going into each legislative session.

After the new numbers came out, Reynolds fired the director of the Department of Human Services, Jerry Foxhoven. Nobody is saying why. Some claim it is because he sent an email to staff about the deceased rapper Tupac Shakur. He said it was because the governor’s office wanted him to do something illegal. Seriously. This is what the statehouse has come to.

State Auditor Rob Sand has sent letters to insurance companies asking them about continuity of care for clients transitioning in the ever-changing program. We have heard nothing more about that. Sand has said that he is investigating the program but not more. Foxhoven said that he has spoken with the Auditor’s Office. Sand has said he is not pining for a fight with the governor.

His instincts are right, we suppose. This issue was hashed out in the governor’s race. Fred Hubbell made the argument that Medicaid privatization is a complete mess, and he actually does understand insurance. He ran Equitable of Iowa. And he got his hat handed to him. Iowans voted for this Medicaid sham. The choice was clear. Iowans picked incompetence. So we suppose we just have to put up with it.

Voluntary money pit

On the issue of incompetence: The state has committed itself to a voluntary nutrient reduction strategy that is supposed to clean up the Mississippi River complex sometime in the next 20 years. The Iowa Environmental Council says it will take more like 900 years at the current rate.

Last year, Iowa spent about $17 million on the strategy. The state estimates it needs about $1.2 billion annually to achieve a 45% reduction in nitrate pollution of the Gulf of Mexico from Iowa farm fields. It will only take 93 years to get 12 million acres of cover crops planted, and 10 times that long to treat 7.7 million acres with wetlands designed to remove nitrates, at current funding levels.

The whole enterprise was designed to look impossible because it is.

You cannot build enough bioswales to counteract the change in the Iowa landscape since 1980, compounded by extreme weather. No wetland is great enough. We need to plant more grass and less corn, especially near streams, and we need to pay farmers through the farm bill to sequester carbon and prevent water pollution.

Several presidential campaigns have caught on. Joe Biden just jumped on board with a new rural resiliency plan that calls on agriculture to lead the way in drawing carbon from the atmosphere into the soil. Farmers will use their acreage in the way that makes a profit. If it comes from native prairie strips in a corn field, they will do it if the government bids higher than corn does. A lot of young farmers could get into the business if they could run a cow-calf herd on rented pasture, but the pastures have disappeared to corn. And that is the precise problem: We plowed up the pastures and through the fencelines, into the river, desperate for every acre to make rent. We must grow 200-bushel corn or die. No bioswale can wash that away. There must be a viable alternative to giving up land and income. It cannot be provided by the state. All we have done is poured money into a fruitless engineering experiment. Our farmers are still broke, and our rivers are polluted.

Articles Section: