Public Policy Positions 

LAI is a thought leader on the policies that help shape high-quality, mission-focused aging services in Iowa. LAI is advocating for policies that remove barriers to care, develop new services, improve reimbursement, plan for the future, and make Iowa a better place serve older adults. 

Take a look at our top policy positions below. The following are LAI's policy asks for lawmakers to make ensure older Iowans have access to the care they need. You can access LAI's Public Policy One-Page here. You can access LAI's 2025 Legislative Agenda here.

Support Higher Medicaid Reimbursement Rates

In Iowa, 1 in 2 nursing home residents rely on Medicaid. However, aging services providers are facing a 16% gap between the cost of providing care and the average FY 2025 Medicaid reimbursement rates. Cost growth has stabilized somewhat, but costs have still grown over twice as fast as revenues since the start of the pandemic. Medicaid rates must increase across the continuum of care to address the cost of delivering care and boost aging services providers’ ability to hire and retain caregivers vital to providing these services.

Focus on Healthcare-Specific Workforce Development and Workforce-Friendly Policies

According to the Iowa Board of Nursing, there were 61,759 Registered Nurses in FY 2022. The projected numbers for FY 2023 show 58,346 Registered Nurses, a loss of 3,413. That means in just one year, Iowa will have lost more than 5% of its Registered Nurse workforce. Aging services providers need the legislature’s help to increase access and bring more nurses and caregiving professionals into the field through expansion of healthcare training programs, tuition assistance and loan repayment, and the establishment of wrap-around supports like affordable housing, transportation, childcare and family services.

Reign in Restrictive Labor Practices of Temporary Staffing Agencies

With action in 2022, the legislature prohibited the restrictive labor practices of temporary staffing agencies. We need accountability for healthcare staffing agencies who continue to charge Medicaid providers rates far in excess of the going wage for essential healthcare workers. Of the 361 Health Care Employment Agencies registered with DIAL in Q3 of 2024, only 13% provided agency workers to Long-Term Care Communities and of these, and only 16 were based in Iowa. These agencies charge exorbitant premiums to facilities desperate to fill staffing gaps, often doubling or tripling normal rates, funneling Medicaid dollars out of the state. Without further reforms, the out-of-control costs will continue to drain taxpayer dollars and the assets of older Iowans.

Study Long-Term Services and Support (LTSS) Financing Options

By 2050, the 65+ population in Iowa is expected to grow to 709,000, or 20.3% of the state’s total population. Iowa’s aging population continues to grow, and most will need long- term services and support during their lifetime. Since the Medicaid program is the largest payer of those services today, the state of Iowa needs to begin planning now through a LTSS Financing Taskforce of key stakeholders to study the issue and propose solutions on how to finance LTSS services over the coming decades.