The next step for Iowa education reform depends almost entirely on trust. Will legislators, school board members and taxpayers trust Gov. Terry Branstad’s plan to dump the annual debate on incremental increases in property taxes and instead count on the state general fund for $400 million in new education funding over the next five years?
Branstad made a strong case in his Condition of the State address Jan. 15, his Wednesday speech to the Quad-Cities Chamber of Commerce and his hour-long discussion that same day with the Times Editorial Board.
“The state’s going to meet its obligation; there will be no more future across-the-board cuts because we have a five-year budget and the money is set aside.”
These are words we’re inclined to believe from a governor focused more on governance than politics. But in the very same conversation, Branstad won’t budge on Medicaid reform for one reason: Trust.
“A lot of states, including ours, are very apprehensive about the federal government’s promise because we know they always grossly underestimated what it’s going to cost. That’s why a lot of governors, including governors in Wisconsin, Michigan, Texas and Florida, as well as here, are very apprehensive about buying in to Medicaid expansion.”
Building trust in education
We share the governor’s skepticism about congressional commitment. Congress — for whatever reason you choose to believe — has been unable to agree on annual budgets, farm bills, energy policy and a host of other long-term appropriation plans.
Without that playbook, Congress has devolved into recurring debate solely on raising the debt limit.
Compare that to Iowa.
Branstad spent three years attempting to build an education coalition that can support large-scale reform. His first comprehensive attempt dissolved under the weight of conflicting interests.
So Branstad changed his game plan. He and Lt. Gov. Kim Reynolds traveled the state to get more input from taxpayers, school board members and teachers. He came back with a narrower, more focused reform plan aimed at anchoring more funding with the state and improving teacher quality, training and pay.
“We ran into a lot of opposition from teachers. We thought, ‘How can we get teachers to buy in?’”
He appealed directly to teachers by incorporating their concerns about mentoring and boosting pay for new teachers. He’s trying to appease skeptical school board members by fashioning a five-year plan he intends to guarantee with state funding, regardless of political or economic winds.
Branstad even changed his tone and rhetoric. In our meeting, Branstad repeated what he told all of Iowa in his Condition of the State address: “Let me be perfectly clear to the teachers here today and teachers in classrooms across Iowa. You are not the problem.”
With new words and a long-term commitment, Branstad has offered Iowans a new direction, not just an emphatic revival of last session’s ideas.
Building trust for health care
After appealing heartily to Iowans, their lawmakers and school boards to trust him on education and property tax reform, the governor confessed to zero faith in Congress’ health care reform. He refuses to compromise on Medicaid expansion under the Affordable Care Act that Q-C health care officials say is essential to control overall health spending.
Instead, he’s banking his healthiest state initiative largely on a modest expansion of Iowa Cares, a program that provides health care to poor Iowans who can make it to University Hospitals in Iowa City or Broadlawns in Des Moines.
Genesis Health System CEO Doug Cropper told our editorial board Jan. 15 that even the rosiest Iowa Cares estimate leaves 80,000 Iowans without health insurance. That includes about 10,000 in Scott County.
“They may be eligible for Iowa Cares, but they’ve got to get to Des Moines or Iowa City,” Cropper said.
Branstad didn’t dispute the implication. He’s just unwilling to trust the federal government with the solution.
The Medicaid expansion is paid for by reducing federal reimbursement to physicians in exchange for bringing millions of Americans under Medicaid. The idea is that Medicaid coverage will bring more uninsured into doctors’ offices for more cost-effective health maintenance of chronic conditions like diabetes, instead of waiting for the symptoms that force an expensive emergency room visit.
As Cropper said, Iowa hospitals and physicians already are enduring these reimbursement cuts. So why not expand Medicaid and get some of that federal cash back to improve health care for more Iowans?
For Branstad, the answer, again, is trust:
“That’s why a lot of governors, including governors in Wisconsin, Michigan, Texas and Florida, as well as here, are very apprehensive about buying in to Medicaid expansion.”
But 22 governors, including eight Republicans, have embraced Medicaid expansion, according to a survey this month by the New England Journal of Medicine. The survey showed support from Republican-led Arizona, Nevada, New Mexico and North Dakota.
So we asked Branstad: “Is there anything the federal government could say to change your thinking on Medicaid?”
“It’s not what they say. I want to see what they’ll do. First, they can pass a budget and show they can provide the funding. I don’t think they will.
“They need to put the country on track for sustainability.”
That’s where Branstad’s type of leadership and outreach to Iowa’s divided Legislature can serve as a national model. Congress must demonstrate governance instead of spouting politics. Governance requires compromise.
Branstad showed how by compromising on his education and property tax reforms to win support — and trust — among state legislators and taxpayers.
Ultimately, Branstad’s trust issues seem less to do with politics than effective governance. He defends his Iowa reforms based on a track record of “leadership that knows what it’s doing. This is not Illinois. This is not the federal government.”
Note his equal-opportunity criticism of a state wrecked by long-standing Democrat leadership and a Congress hobbled by a GOP-led U.S. House.
Leadership is demonstrated through effective compromise, not rhetorical intransigence.
Branstad is offering a national model of governance that could break the gridlock in Congress and restore the trust essential to improving health care, and almost every other problem facing our nation.