Governor introduces bill on rural health care access, medical residencies
Gov. Kim Reynolds was joined by health care professionals Tuesday as she highlighted her legislative proposals to tackle workforce shortages and rural access to health care in Iowa.
was introduced to the Legislature Monday and is scheduled for a Wednesday subcommittee meeting. The bill would consolidate and increase funding for Iowa’s current five student loan repayment programs and increase funding to $10 million as well as opening the incentive to any person, even those trained out-of-state, who commits to practicing in high-demand areas for five years.
The bill also directs the Iowa Department of Health and Human Services to work on drawing down than $150 million in federal funding to create a projected 115 new residency slots at teaching hospitals in the state.
HHS would work with the University of Iowa and Broadlawns Medical Center to seek the federal funding. Proctor Lureman, CEO of Broadlawns, shared examples of Iowans who did their medical residencies through Broadlawns who decided to stay in the state in fields from family medicine to mental health. He said many who do their residency in Iowa end up staying.
“The stories that I highlighted this morning lean heavily on Iowa roots, though Broadlawns has had many residents that have come from out of state, done their residency here and fallen in love with the state that we all love and now call it home,” Lureman said. “In summary, yes, the expansion of residency slots increased physician retention, strengthened health care access. And I want to personally thank Governor Reynolds for all of the hundreds of new residency slots that we will have in the coming year.”
The state is seeking federal funding to help implement this expansion as the Trump administration, through the U.S. DOGE Service, is seeking to make cuts to federal spending. Reynolds said she felt “really good” about the chances for approval.
“We’re going to make a strong case for it, for approval,” Reynolds said. “We feel pretty confident — the good news is there are a lot of other states that are already doing this that have taken advantage, and remember — we’re sending up state dollars to draw down federal dollars, so we have some skin in the game.”
Iowa HHS Director Kelly Garcia said the request to federal officials has yet to be finalized, but that the state is aiming to launch new residencies July 1.
The proposal would also make changes that Reynolds said will help support rural health care providers with a focus on OB-GYN services, unbundling Medicaid maternal rates and allocating $642,000 to increase rates for providers serving mothers and infants.
Iowa HHS would also be directed to seek federal approval for Medicaid rate flexibility “with the goal of incentivizing creative regional partnerships,” and to establish a “hub-and-spoke” funding model for rural health care systems. This approach would be modeled after the existing Centers of Excellence Program, regional providers of specialized health care in rural areas.
Reynolds said these changes are seen through the growing number of counties that receive coverage through Centers of Excellence, and that improving regional health care provisions will help address shortages of care in rural areas.
“We’re really looking at, where are the gaps?” Reynolds said. “How can we make this health care system stronger across the state? So we look forward to working on that as well. I truly look forward to working with the House and Senate to pass this important legislation and really sign it into law as quickly as possible.”
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