Yesterday marked the second funnel deadline – the date by which the majority of policy bills must have passed a full chamber and a committee in the opposite chamber in order to remain viable for consideration this session. This week saw a flurry of activity on several issues of interest to the medical community, as advocates pushed to advance policy measures ahead of this crucial deadline.
Of the more than twenty anti-vaccine measures introduced this session, three advanced out of committee to survive the first funnel deadline:
- SF 125 – Listing Vaccine History on Infant Medical Examiner Investigation Forms
- HF 769 – Mandating IRIS Use & VAERS Reporting for Any Adverse Event 8 Weeks Post-Vaccination
- SF 555 – Prohibiting Employer Mandates to Receive the COVID-19 Vaccine and Listing Vaccination Status on State IDs
Over the past few weeks, Informed Choice Iowa (ICI) – the anti-vaccine advocacy group – has been aggressively advocating for further action on the bills, focusing primarily on the two Senate bills as ICI opposes the IRIS use mandate in HF 769. IMS has been working closely with a coalition of patient and provider groups to oppose the measures. This week, we saw a last-minute push to advance SF 555, first as a stand-alone bill and then as an amendment on another bill coming out of committee, in an effort to keep the measure alive. IMS worked closely with our partners in the business community who strongly oppose the legislation, to halt these efforts. All three bills died in this week’s funnel, however, we expect to see SF 555 reappear in some form later in the session.
Medical School & Residency Admissions
On Tuesday, a Senate subcommittee met to consider HF 468, which would mandate that at least 75% of all students admitted to the University of Iowa medical and dental school either be an Iowa resident or have received their undergraduate degree from an institution in Iowa. Officials from the University of Iowa report that currently approximately 70% of admissions would meet these criteria so the impact of this bill would be negligible. It would, however, still result in a reduction in tuition paid by out-of-state residents of approximately $1 million.
At Tuesday’s subcommittee meeting, the Senate floor manager for the bill announced that the Education Committee was considering amending HF 468 to also incorporate the elements of HF 487. This more controversial bill would require select residency programs at the University of Iowa to offer an interview to any applicant who is an Iowa resident or who completed their undergraduate degree in Iowa. Impacted residencies would include OB/GYN, Psychiatry, General Surgery, Emergency Medicine, Cardiology, Neurology, and Primary Care. In addition, all University of Iowa residency programs would be required to offer an audition rotation to any Des Moines University medical student who applied for their program.
During the subcommittee meeting, the senators expressed concerns with the logistical implications of HF 487 and questioned the need for HF 468 when the University of Iowa is already nearly achieving this threshold without a mandate. The subcommittee opted to still move the bill forward and on Thursday the Senate Education Committee voted to move HF 468 with the amendment language to integrate the components of HF 487, to the full Senate for consideration.
Telehealth Payment Parity
This session has seen extensive discussion of telehealth commercial payment parity as legislators recognize the crucial role this technology has played throughout the pandemic. Discussions have been slowed considerably by the Wellmark proposal to increase telehealth payment from 50% of in-person rates for physical health services and 75% of in-person rates for behavioral health services, to 70% of in-person care for physical health and 85% of in-person rates for behavioral health services. Providers who meet certain service criteria would then qualify for a further increase in payment rates, initially up to 95% of in-person rates and eventually 90% of in-person rates.
The House has advanced multiple payment parity bills this year, including HF 294 to enact 100% commercial payment parity for behavioral health services. The Senate has consistently declined to take these measures up and the standalone bills died in yesterday’s second funnel. On Thursday morning, the House Human Resources Committee took steps to keep the issue alive, opting to amend the contents of HF 294 on to SF 524 – legislation the full Senate has previously passed to establish a psychiatric bed tracking study committee. SF 524, which unanimously passed out of House Human Resources Committee, is now funnel-proof and viable for consideration through the end of the session. It is expected the full House will pass the amended SF 524 back to the Senate where it is unlikely to advance so long as the telehealth parity language is included.