Policy Prescriptions for this Crisis

The COVID-19 pandemic poses an immediate threat to our physical health. The policy response to this crisis may affect the economic and financial health of Iowans for years to come.


Goal: Protect the health, safety, and economic opportunity of all Iowans.

Objective: Solve short-term problems in ways that don’t hamper long-term recovery. When restrictions are eased, the economy can quickly recover to the fullest extent possible.

Caution: Just as the virus can harm our physical health, bad policies can make the economic damage worse. If needs increase and resources decrease, the public’s health and safety would suffer as a result.

Iowa needs to respond with prudent, short-term expenditures, prioritizing people and businesses affected by the pandemic, and relaxing government authority to improve the ability to both respond to the current crisis and boost economic recovery.


Correct Policy Prescriptions

Waive or Repeal Certificate of Need:

Iowa’s “certificate of need” law requires hospitals and other medical facilities to get special permission before building or expanding, and health care providers to go through a lengthy and expensive process for new or replacement equipment and services. One study estimates that laws like this have reduced the number of hospital beds by about 10%, with minimal savings. A dozen states operate more efficiently without such laws.

In recent years, many lawmakers didn't take CON reform seriously enough. It shouldn't take a pandemic to get rid of this archaic law. Iowa should waive these requirements during the current emergency and repeal them altogether when the crisis is over.

Promote Telemedicine:

Iowa needs to make it easier to receive medical advice over the phone and through video chatting with a medical professional.

Dr. Tania Elliott, immunology and telemedicine expert, said, “Medicine is about the art of observation. I can observe a patient taking a deep breath, if they are coughing or sweating, and if they can speak a complete sentence.” If problems are present, tests can be ordered, and medicines prescribed.

Iowa should take advantage of the networks and infrastructure already in place to combat this coronavirus, and telemedicine should be encouraged and promoted rather than restricted and limited.

Cut Occupational Licensing Red Tape:

Occupational licensing can serve to protect health and safety, but too often, it creates excessive barriers to work. In times like this, licensing can even prove to do more harm than good.

Fortunately, Governor Reynolds recognized the potential harm and loosened some licensing restrictions in the medical field. In her Proclamation of Disaster Emergency, the Governor:

- Allows for temporary medical licenses to be granted to assist with COVID-19 response for individuals who held a license within the last five years but are not current

- Reduces the number of hours of experience needed for medical students for a license if their supervising institution of higher learning deems that their skillset is sufficient to practice

At a time when additional burden is placed on the medical field, waivers like these are critical to ensuring that staffing levels are able to be maintained. Other temporary reforms that other states have utilized include:

- Interstate reciprocity for healthcare licenses

- Streamlined universal recognition that allows individuals licensed in another state in the medical field to become licensed within one day

If people are available who have the needed skillsets to assist with healthcare surrounding this pandemic, the government should not disallow them from helping. Unnecessary barriers to work in the medical field at this time will do more harm than good. Looking to the future, legislators need to make these permanent.


Distinguish between Emergency and General Fund spending

The funds used for the COVID-19 emergency should not be intermingled with other funds in the state budget process or assumed to be ongoing spending that will be included in future state budgets. Iowa has wisely built up cash reserves; our state government could operate for 37 days solely on reserve funds. This is higher than the 50-state median amount of 27.9 days and 13th highest in the country. Reserve funds could reasonably be used in the case of emergency without creating a greater burden on ongoing revenues.

Distinguish between Emergency and General Fund spending
The funds used for the COVID-19 emergency should not be intermingled with other funds in the state budget process or assumed to be ongoing spending that will be included in future state budgets.


Policy Prescription Don't Do List

Create Ongoing Financial Obligations with One-Time Funds:

New government programs might require ongoing sources of revenue. Any one-time funds received from the federal government through a stimulus package should be used first to address any state revenue shortfall and then for short-term measures that expire once the federal funds do.


Suspend Government Transparency Requirements:

At a time when state and local governments are using emergency powers, open records and public meetings are essential to preserving the public's confidence and trust in government.

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