Meeting Public Comments

Subcommittee meeting and times are as follows:

A bill for an act relating to the supplemental nutrition assistance program, the medical assistance program, the Iowa health and wellness plan, and other programs under the purview of the department of health and human services and including effective date provisions. (Formerly SSB 3140.)

Subcommittee members: Harris-CH, Meyer, A., Wessel-Kroeschell

Date: Tuesday, March 10, 2026

Time: 8:00 AM - 8:30 AM

Location: RM 103

Names and comments are public records. Remaining information is considered a confidential record.

Comments Submitted:

03-05-2026

Amanda Tollari

Locking the state into using MCO's is a mistake. They benefit from denying care to the most vulnerable Iowans. MCO's cost the state more money and provide poor service. My daughter has used both traditional Medicaid and an MCO. She is back on traditional Medicaid with an amazing social worker through Easter Seals because of the HIPP Program. I am worried this bill will impact the HIPP program. We should feed hungry babies. The cruelty of this is evident.

03-06-2026

Kay Marcel [Family Caregiver]

Locking the state of Iowa's Medicaid services into using MCOs (Managed Care Organizations) as called for in DIVISION III of SF 2422 is shameful. MCO's make money off denying care to the most vulnerable Iowans like my fortyseven (47) yearold son who has an Intellectual Developmental Disability (IDD) and several chronic health conditions. Why would legislators vote for something so awful? Basically this would make us use MCO's even if there was something else that would save the state money. Iowans do not need to be locked in. We have not been locked in since 2016 when the state privatized IA's Medicaid program through Governor Branstad's Executive Order and went to MCOs. Why is this a priority now? I urge members of the subcommittee to offer and approve an amendment to remove DIVISION III from SF 2422.

03-06-2026

Brian Larkin [Parent of child with special needs]

Dear committee members,I strongly urge you to deny passage of SF2422. While there may be a few positive items in the bill as proposed, the items pertaining to Health and Human Services and effective date provisions are incredibly troubling, and need more research and examination before being approved and made law. The bill ties the hands of any future legislatures from finding a better way to be stewards of taxpayer money regarding the Managed Care Organizations (MCOs). The MCOs have been detrimental to the care and wellbeing of disabled children, adults and their families ever since April 1, 2016. What was sold to taxpayers as a money saving device has basically been a money grab for insurance companies while disabled Iowans have been denied essential services, their family members have endured undue stress and expenses to care for their children. Some family members have been forced to quit their jobs to care for family members.I urge you to kill this bill in committee.Thank you

03-06-2026

Gloria Campbell

Locking the state of Iowa into privatized HMOs will negatively impact those with disabilities and those on Medicaid. Bills that prevent flexibility for Iowas future make no sense. Let Iowa continue to do what is best based upon those voted in to office. These prevention bills show that Republicans acknowledge the favortism these private contractors are getting.

03-06-2026

Jennifer Gero

Dear Members of the Subcommittee,I strongly urge you to oppose legislation that would permanently lock Iowa into a privatized Medicaid system run by MCOs. Iowas 2016 transition revealed significant problems, including delayed provider payments, increased administrative burdens, and reduced access to care for vulnerable Iowans. Because MCOs are private corporations, their financial incentives have conflicted with patient care, leading to service delays, denials, and complicated appeals processes for seniors, people with disabilities, and lowincome families. It has reduced transparency and limited legislative oversight, adding administrative costs that do not improve patient care. Worst of all, permanently embedding this model in law would remove the flexibility future lawmakers need to improve the program. Medicaid must prioritize access, accountability, and patient outcomes over corporate profit. I urge you to reject legislation that would bind Iowa to this deeply flawed system.

03-06-2026

Ashley DeLayo

I strongly urge you to oppose legislation that would permanently lock Iowa into a privatized Medicaid system run by Managed Care Organizations (MCOs). MCOs have proven to not be in the best interest of Iowans. Issues include delayed provider payments, increased administrative burdens, and reduced access to care for vulnerable Iowans. Because MCOs are private corporations, their financial incentives have conflicted with patient care, leading to service delays, denials, and complicated appeals processes for seniors, people with disabilities, and lowincome families. It has reduced transparency and limited legislative oversight, adding administrative costs that do not improve patient care. Permanently embedding this model by law would remove the flexibility future lawmakers need to improve the program. Medicaid must prioritize access, accountability, and patient outcomes over corporate profit. I urge you to reject legislation!

03-06-2026

Kerwin Van Wyk

03-06-2026

Rebecca Coffin

I strongly urge you to oppose legislation that would permanently lock lowa into a privatized Medicaid system run by MCOs. Iowa's 2016 transition revealed significant problems, including delayed provider payments, increased administrative burdens, and reduced access to care for vulnerable lowans. Because MCOs are private corporations, their financial incentives have conflicted with patient care, leading to service delays, denials, and complicated appeals processes for seniors, people with disabilities, and lowincome families. It has reduced transparency ,limited legislative oversight, adding administrative costs that do not improve patient care. Worst of all, permanently embedding this model in law would remove the flexibility future lawmakers need to improve the program. Medicaid must prioritize access, accountability, and patient outcomes over corporate profit. I urge you to reject legislation that would bind lowa to this deeply flawed system.

03-06-2026

Natalie McLain

03-06-2026

Linda Reineke

Since implementing MCO's, services for our son has been okay. But they are scrutinized more thoroughly as if he will get over having Down's Syndrome. They are all about their bottom line. Because he doesn't have any drastic medical needs, respite savings that could be used for medically necessary equipment, is returned to the MCO every year is unused and added to their profits. It is mandated to budget for it and is in the thousands of dollars. MCO'S, writing their own rules, is an issue. They are more concerned about their stock holders and very little about the consumers.My son has had CCO for 25 years. The services he receives are vital to him being part of the community, receiving the assistance he needs in housekeeping, transportation, independence. Since MCO's took over, I see the services provided being slowly eroded away in lieu of cuts that give them more money. Please go back to Medicaid managing the care for those who most need it.

03-07-2026

Renee Speh

Do not lock Iowa into the MCO system. My adult son has 2 waivers and Medicaid. He has had a hard time getting all the services he is entitled to. Service providers need a higher reimbursement rate so they can raise Direct Service Provider wages and improve longevity. MCO incentives cause loss of services for people with disabilities.

03-07-2026

Cindy Newton [Special Education Teacher/Advocate]

Dear Members of the Subcommittee,As a special education teacher who works every day with some of our communitys most vulnerable students, I urge you to oppose legislation that would permanently lock Iowa into a privatized Medicaid system run by Managed Care Organizations (MCOs).Many of the students I serve rely on Medicaidfunded services such as therapies, mental health care, and specialized medical supports in order to learn, communicate, and participate in school. When those services are delayed, denied, or buried in complicated appeals processes, it directly affects their ability to succeed in the classroom and in life.Iowas transition to MCOs in 2016 revealed serious and ongoing problems, including delayed provider payments, increased administrative burdens for families and providers, and reduced access to care. Families I work with already face tremendous challenges advocating for their childrens needs. When private insurance corporations place financial incentives ahead

03-07-2026

Denise Perez

I strongly urge you to oppose legislation that would permanently lock Iowa into a privatized Medicaid system run by MCOs. Iowas 2016 transition revealed significant problems, including delayed provider payments, increased administrative burdens, and reduced access to care for vulnerable Iowans. Because MCOs are private corporations, their financial incentives have conflicted with patient care, leading to service delays, denials, and complicated appeals processes for seniors, people with disabilities, and lowincome families. It has reduced transparency and limited legislative oversight, adding administrative costs that do not improve patient care. Worst of all, permanently embedding this model in law would remove the flexibility future lawmakers need to improve the program. Medicaid must prioritize access, accountability, and patient outcomes over corporate profit. I urge you to reject legislation that would bind Iowa to this deeply flawed system.

03-07-2026

Amber Gale

Im the parent of a medically complex child who relies on Medicaid, and Im concerned about the provision in SF 2422 that would require Iowa Medicaid to continue operating through managed care organizations.Our family has experienced denials of services that physicians believed were medically necessary, forcing us into the appeal process. Most recently, we began an appeal that we had to abandon when AJ required open heart surgery. When a child is facing major surgery, families simply dont have the capacity to simultaneously fight an insurance appeal.Im currently in Boston while my child recovers from that surgery. Situations like this are exactly why many families cannot realistically complete lengthy appeals.Locking a single Medicaid delivery model into statute could limit the Legislatures flexibility to address oversight concerns or make improvements if the system isnt working as intended. I urge lawmakers not to lock Iowas Medicaid program into a single delivery model.

Attachment

03-07-2026

Laura Zimmerman

I urge you to vote no on codifying MCOs in this state. They have cost the state more money, resulted in chaos, caused service providers to close because they cant get paid, and people to die because they were denied care. Instead of codifying an executive order that has been harmful and expensive, I urge you to look at cost effective solutions to ensure all Iowans have access to affordable, quality care and services. Iowans deserve better than for profit out of state companies making money on the backs of the most vulnerable Iowans and the state taxpayers.

03-07-2026

Melissa Timmer

I am a parent. I am a caregiver. I am an Independent Support Broker with CCO. But my most important job above all of these is advocate. Advocating for those who I have worked for & with for over 25 years in the disability/human services field in Iowa...but most importantly for my son!The mass chaos that started in 2016 with privatizing medicaid in Iowa has not slowed down. The MCOs have proven they are not in this to provide adequate services for members that are disabled. They are in this for money. To pay a CEO and administration 6 figures or more per year, plus bonuses, when our HCBS waiver members & advocates are FIGHTING just to be able to stay alive & safe with appropriate medical care & services. Choosing to make & support a law that doesn't allow for voices to be heard in the state of Iowa is called DICTATORSHIP! We live in a country of freedom, but this bill will take away the freedom of voices of those that are most vulnerable. Choose LIFE & SUPPORT by saying no!

03-09-2026

Joy Newcom

Please do NOT vote to permanently privatize Medicaid. I have an adult child with disabilities who has been on Medicaid before privatization and after. I also serve as guardian for several other adults with intellectual and physical disabilities who have experienced both systems as well. To a person, each has suffered from denials to their care under Iowas privatized version. These concerns were forecasted to Gov. Branstad before the change. They became reality after privatization. Iowas legislators have ignored the problems. Our states most vulnerable carry the burden of your neglect. Do not make things substantially worse.

03-09-2026

Jessica Roman

I work with families of very young children with disabilities and developmental delays. I routinely see children dropped from Medicaid without explanation or notification; parents discover it when they take their child to the doctor. Most have had benefits reinstated with the explanation that it was a glitch, but in the mean time, have missed medical appointments or lost their place on a wait list. I have seen coverage denied for prescribed formula for tube feeds, AFOs, & brandnamed meds when the generic caused a reaction. One terminally ill child was denied a stander b/c it wouldnt prolong his life, only improve the quality. MCOs are only interested in profit, not the lives and wellbeing of kids, and this bill guarantees that Iowa kids will continue to pay for those profits. This privatization is a failed experiment, & in no way should Iowa families be locked in to this mess.

03-09-2026

Joel Vander Molen

Locking Iowa into using MCOs is neither in the state's or people's best interest. Using a forprofit company means services are reduced for members and patient care decreases. This has been widely reported across Iowa and has caused the closure of some service centers. Straight Medicaid is also less expensive for Iowa and provides better quality care.Please vote no on this bill and allow Iowa's future Medicaid funding more flexibility.

03-09-2026

Joshua Olney

I strongly oppose SF 2422. My 14yearold daughter is 100% physically/mentally disabled. She is the heart of our home, and our household only functions when her complex needs are met. We currently rely on HIPP and feeforservice to maintain her specialized network of care.I urge you to consider the extreme administrative burden families like mine already carry. I act as a de facto case manager: tracking employee hours, managing medical daycare timekeeping, and coordinating respite care and equipment proposals. Adding a corporate MCO "middleman" for "oversight" does not help us; it creates a single point of failure where a "prior authorization" delay can destabilize our entire home.Her needs are rapidly evolving. The care she requires at 14 will not be the care she needs at 18. By locking in current programs and banning new FFS options after 2027, this bill ignores the reality that a disabled childs care plan must be flexible. Reject the MCO lockin in SF 2422.

03-09-2026

Susan Leeper

Please do not privatize Iowas Medicare system. For profit companies cannot be trusted to do whats best for our most vulnerable. Healthcare is already an incredibly broken system in our country, and we need to make things better for those who need it most, not an uphill battle. I have a friend with an adult son with disabilities, and she is terrified about the possibility of a private system

03-09-2026

Kevin Harris

A narrow focus on waste, fraud, and abusecombined with budgetneutral accounting requirements that effectively mandate the use of MCOs for Medicaidlimits HHSs ability to identify and implement innovative, costsaving approaches that maintain or improve service quality. If a feeforservice model can be designed that delivers equal or better outcomes at a lower cost to the state, HHS should have the flexibility to pursue and implement that solution.

03-09-2026

Jessica Teague

I have not been receiving good services from our mco provider and the hours and services awarded vs the client requiring 24/7 care are not even close. This is proving that mco providers do not care for the clients well being or needs. We need to be able to decide if we want an mco or not.

03-09-2026

Maggie Brown

I am the aunt/guardian of a mentally disabled adult. Locking him into a MCO would not be in his best interests. He gets his care through Medicaid right now. Changing that would cause delays in his therapies and doctors he is comfortable with. Maybe you don't understand the impact of that change on a special needs individual. It is extremely stressful for all involved. Keeping him where he knows what to expect and building a rapport with therapists, case workers, and doctors helps balance the frustration and fear he experiences. Since he doesn't have a voice to vote, I'm advocating for him and all special needs individuals. Please listen and do not pass SF2422. These individuals deserve their rights. Forcing them to adhere to laws that can't be changed in the future is just plain wrong.

03-09-2026

Karen Thies

Dear Members of the Subcommittee,I strongly urge you to oppose SF 2422, specifically DIVISION III, which would permanently lock Iowa into a privatized Medicaid system run by MCOs.My 23yearold son is on the IDD waiver and the HIPP program. Because he has feeforservice Medicaid and case management through ChildServe, we have successfully navigated the systemeven during a 2021 crisis that put him in intensive care for 8 weeks. For over a year of recovery, HIPP determined that traditional Medicaid remained the most costeffective way to provide his care.Privatization often prioritizes profit over patients. Locking Iowa into this model eliminates flexibility for future legislatures and harms families who rely on the transparency of feeforservice care. Please remove DIVISION III or reject SF 2422 to protect vulnerable Iowans and preserve our ability to improve the Medicaid system.

03-09-2026

Hannah Keep

03-09-2026

Nancy Baker Curtis [Caregiver]

Dear HHS Committee, My name is Nancy Baker Curtis. I am the parent of a 10 year old does not speak with word. In the past 3 years he has begun to walk with a reverse walker. While my son has begun to ambulate with assistance, it doesn't negate his need for a wheelchair.Unfortunately, our primary insurance doesn't allow for preauthorizations for durable medical equipment. We applied and were denied. This meant that our only hope to get the wheelchair was through a Medicaid Waiver. We were denied 3 times. The MCO cited a lack of need. I filed an appeal. The appeal was denied. I filed for a peer review between our primary care physician and the MCO doctor. Not only did the MCO doctor arrive at the meeting 30 minutes late, he denied the appeal stating there was no need for a wheelchair. Although the MCO doctor had never met my son or evaluated him, he continued to deny the request for a chair. Mutual acquaintances helped push luck in our favor. Luck shouldn't be the factor. Vote NO!

03-09-2026

Stacy Volmer

Strongly Opposed! Senate File 2422 would dangerously lock Iowa into privatized Medicaid managed care organizations, prioritizing insurance company contracts over the needs of Iowans. As a parent of children with significant disabilities who rely on Medicaid, I strongly oppose tying the states hands to private MCOs whose primary obligation is to shareholders, not patients. Iowa must retain the flexibility to reform, or end, privatized Medicaid if it fails families. Enshrining this system in law protects corporate interests while vulnerable Iowans face delays, denials, and reduced access to care. Medicaid should serve patients, not insurance companies. This bill moves Iowa in the wrong direction and risks the health and stability of people who depend on this program. Lawmakers should reject Senate File 2422.

03-09-2026

Garret Frey [N/A]

As a 43yearold ventilatordependent quadriplegic who relies on Medicaid to survive, I strongly oppose this bill.Many disability advocates are concerned that SF 2422 could lock Iowa into the managed care system, making it extremely difficult to change, even if the system continues to fail Medicaid members.Since Medicaid was privatized, many of us have experienced: Delays in services Denials of medically necessary care Reduced provider networks Endless bureaucracy between agencies & private contractorsOne of the biggest problems is that providers are walking away from Medicaid. It's big business and profits over people, and I can show you all that the numbers that makes sense. This is where the fraud, waste, and abuse comes from and it's from the top down. Let's fix the system. It's a serious issue. These are lifesustaining services.Healthcare decisions should be made by patients and doctors, not insurance companies.I urge Iowa legislators to vote NO on SF 2422.

Attachment

03-09-2026

Jennifer Wolff [Disability Advocate ]

Im struggling with my comments. People with disabilities, their families and friends and caregivers, as well as medical professionals have shared the significant issues everyone has experienced and continue to experience since Medicaid was privatized. None of the goals of privatizing Medicaid (better budget, lower costs, better outcomes etc) have even come close to being met. By locking the state into utilizing Medicaid, you also lose the ability to change if something different comes along that could potential benefit everyone. We exist in a time where many things are changing. We should allow our state to allow change and allow the democratic system to work further us rather than limit us.

03-09-2026

Emy Gregg

As a healthcare worker who sees patients with MCOs on a daily basis, I urge you to not codify the state into continued MCO use. My patients are the ones who will suffer, moreso than they already are at the expense of making the MCOs more profit. The amount of denials I see and hear about is astounding. Sadly, many of my patients lose the will to fight for what should rightfully be covered and just do without. When these patients do without services and medications that have been prescribed as medically necessary by their care team, they only end up more sick, and utilizing more resources like the emergency room. MCOs have made money handover fist by denying these patients over and over again. Please dont force Iowans into use of MCOs in perpetuity if there could be a better solution that would be more fiscally responsible and allow patients to get the care that they need.

03-09-2026

Colleen Knipper

Please oppose this bill. Among other concerns, locking the state into private MCOs hurts Iowans. As a physical therapist, the number of denials my clients have experienced for medically necessary equipment and services has substantially increased with the MCOs in recent years. Denials delay or prevent Iowans from receiving the medical equipment, repairs or maintenance that they need to engage and participate in their daily routines and activities. The state needs to have the option to continually search for the best options to support our most vulnerable citizens, not be locked in to companies that do not have our best interests in mind.

03-09-2026

Delaine Petersen [The Arc of Iowa]

AS parents of a 52 y/o with profound disabilities, the ID waiver has been very helpful in keeping our daughter at home. In the last 10 years, services unde MCO's have been exceedingly difficult to maintain even though she is the same person before MCO's. This bill to lock in MCO's into the future is crazy. This is a disservice to taxpayers as new altenatives may emerge. More detrimental is forcing Iowans not even born yet to enter a system wher there is not evidence that it will be sound, fiscally responsible and responsive to the needs of IOwans. Unless you have a crystal ball, you are playing with peoples lives and assuming you know what is best for those reliant on Medicaid. This bill does nothing to improve Iowa or service to its citizens

03-09-2026

Pamela Vogel

Please oppose this bill. As one with a sister with Down Syndrome and as a former special education teacher, I am well aware of the fact that too many denials occur for those who truly need help and time is not on their side.I urge you to oppose legislation that would permanently lock Iowa into a privatized Medicaid system run by Managed Care Organizations (MCOs)

03-09-2026

Jessica Smith

I am a mother to a medically complex child and professionally am a speechlanguage pathologist with the AEA. I strongly OPPOSE this bill and everything that encompasses privatizing Medicaid in our state. This plan would hurt the most vulnerable children and their families whom are already dealing with immense difficulties managing their childs care. Medicaid needs to be accessible for those with special healthcare needs and not a business venture for entrepreneurs.

03-09-2026

Kerri Schwemm

OPPOSE this bill. Ive witnessed the struggle that families of children have with obtaining services through MCOs, specifically related to critically needed speech generating devices so that the child can communicate their basic needs. Everybody deserves a voice and locking Iowa into MCOs threaten the process for obtaining that right.

03-09-2026

Christy Brown

Dear Members of the Subcommittee,I strongly urge you to oppose legislation that would permanently lock Iowa into a privatized Medicaid system run by MCOs. Iowas 2016 transition revealed significant problems, including delayed provider payments, increased administrative burdens, and reduced access to care for vulnerable Iowans. Because MCOs are private corporations, their financial incentives have conflicted with patient care, leading to service delays, denials, and complicated appeals processes for seniors, people with disabilities, and lowincome families. It has reduced transparency and limited legislative oversight, adding administrative costs that do not improve patient care. Worst of all, permanently embedding this model in law would remove the flexibility future lawmakers need to fix the barriers vulnerable Iowans face and is not cost effective.

03-09-2026

Tracy Kroeger

I strongly oppose the wording in this bill (DIVISION III specifically) that locks Iowa into continuing Medicaid privatization. Private companies prioritize profits over patient care and covering claims. This is making things harder for our most vulnerable citizens, including children with disabilities and their families. I am the parent to a special needs child who is covered under Iowa Medicaid through HIPP/fee for service. I have had no issues with getting things covered or coordinating care; the same can not be said for families using MCOs. We should make things easier for people receiving care and more efficient for the state, and that is getting rid of Medicaid privatization. I realize this bill will not achieve that. Rather, this bill will make that goal much harder to attain, and as you can see from the public comments listed here nearly everyone is opposed to the part of this legislation that locks in Medicaid privatization. Please listen to these families and constituents.

03-10-2026

Marie Erpelding [Caregiver]

Members of the Subcommittee, I strongly urge you to oppose SF 2422, specifically DIVISION III, which would permanently lock Iowa into a privatized Medicaid system run by MCOs.My 22 year old son is on the IDD waiver and the HIPP program. Because he has feeforservice Medicaid and case management through ChildServe, we have successfully navigated the system even during a major mobility surgery and year long recovery that has greatly improved his life. The HIPP program determines cost effectiveness to the state while offering a wider network of care providers and benefits for our most vulnerable. Having choices seems to be a high priority in Iowa when it comes to education, it should be the same in this sector.

03-10-2026

Erin BOLLMAN

My son is medically complex and intellectually disabled. The MCOs (we have now used two of them) tend to deny claims to Iowa's most vulnerable population and then call it "savings" to the state. Our experience with the MCOs is vastly different than it was in dealing with straight Medicaid. They draw out requests, cite policy they can never show us proof of and overall care more about their paychecks than the people they serve. This is not okay to do to people with disabilities who rely on services just to survive.

03-10-2026

Kristina Richey [481064166]

Dear Members of the Subcommittee, I would encourage you to vote no on SF 2422. The concerns with Managed Care Organizations have been longstanding with since their implementation. When they first started in Iowa, we heard from other states that onethird of the providers would close, onethird of the providers would merge, and onethird of the providers would manage to get through. The merging of agencies has limited and restricted access to services. I have witnessed that many of these agencies have closed local offices and provide only limited coverage in the area they have taken over. Recently there is a higher rate of provider closings or discontinuation of services, especially in rural areas. Locking the state into continued privatization appears to be contrary to the legislation passed to support pharmacies. The additional stress families undergo on a daily basis is real. Locking the state into this future without the ability to explore other options, just doesn't seem right.

03-10-2026

David Anderson

This bill will result in less money coming into our state, and will drive people (especially vulnerable children) out. Both of these will shrink our economy at a time when our growth is the slowest in the nation. Vote No on SF 2422.