Urgent Call to Action

From the desk of Shelley Chandler, IACP Executive Director

This is by far the biggest threat to Medicaid we have ever faced. We URGE you to contact Senator Ernst and Senator Grassley by phone and email, send this out to your staff, families, and local media (early next week). They MUST hear from Iowans impacted by this draft. Now is the time for our voices to be heard.
Contact Information:

Senator Grassley – www.grassley.senate.gov/constituents/questions-and-comments – phone: 202-224-3744
Senator Ernst – www.ernst.senate.gov/public/index.cfm/email-joni – phone: 202-224-3254

Thank You,
Shelly Chandler, Executive Director
Iowa Association of Community Providers


Senator Joni Ernst and Senator Chuck Grassley,

The Iowa Association of Community Providers (IACP) is opposed to the Senate draft, released Thursday,
June 22
(the Better Care Reconciliation Act of 2017). It will cripple the 145 IACP member organizations that serve over 140,000 Iowans supported in community mental health and disability services. As you are aware, nearly 100% of these services are funded by Medicaid to help these vulnerable Iowans live, learn, and work in their community of choice. Medicaid fundamentally changes to a per capita cap program beginning Fiscal Year 2020. The base year calculation in the Senate version changes use of the FY16 fiscal year to an average of 8 consecutive quarters between first quarter FY14 and third quarter FY17.

The Senate version DECREASES the amount to mental health and disability programs by downgrading the growth rate from the House version of CPI-M+1%, to CPI-M+1% until FY2025, and then dropping to CPI-U from thereon.

In a nutshell, the CPI-M is projected to grow at about 3.7% over the next decade, CPI-U is projected to grow at 2.4% over the next decade. The Senate is creating more federal “savings” with this change.

The very concerns we discussed with you last week regarding maintenance of effort and institutional bias have been completely validated with this draft.

The new bill shifts hundreds of billions of dollars in costs to states. At a time when Iowa faces over $100M shortfall in its current budget year, this is clearly not sustainable.

The proposed cuts to Medicaid disproportionately harm those who rely on Medicaid for lifesaving opioid addiction treatment, at a time when mortality from the opioid epidemic is growing at a devastating rate. We are facing a national emergency on opioids.

The proposed one-year grant fund for mental health and addiction treatment in 2018 doesn’t come close to meeting the real—and growing—need for care. Grants are not a substitute for health coverage. We don’t rely on grants for the treatment of heart disease or cancer. Addiction and mental health should be no different.
Congress has made incredible strides in advancing access to care for disability, mental illness, and addiction services in recent years.

On the anniversary of the Olmstead decision, the Senate is proposing a bill that would decimate community services to Iowans. Without funding and supports, community integration (as defined by the Americans with Disabilities Act and affirmed by the Olmstead Supreme Court decision) becomes a meaningless promise.

We URGE you to ensure that revisions are made to protect the 140,000 Iowans who will suffer if this draft moves forward in its current form.

Shelly Chandler, Executive Director