September 17, 2015
DES MOINES — The state Senators responsible for health care policy and funding have asked Obama Administration officials to stop or significantly slow down Governor Branstad’s massive effort to privatize Iowa Medicaid services.
The letter from Senator Amanda Ragan of Mason City and Senator Liz Mathis of Robins notes that the Branstad/Reynolds Administration has a deadly record of failure when it comes to making changes in health care services:
“We have already witnessed the tragic and unnecessary deaths of three Iowans caused by the Governor’s unilateral decision to close two mental health institutes in our state. The Governor appears to be on a similar path with his hasty, unilateral decision to privatize Iowa’s Medicaid program. That’s why we are worried that hundreds or even thousands of Iowans will be put at risk by management companies that will profit by denying critical services to seniors, people with physical and mental disabilities, children and moms.”
More than 560,000 Iowans, approximately one out of five, depend on Medicaid for vital health care services.
The joint letter was sent Thursday to Andrew Slavitt, the Acting Administrator of the federal Centers for Medicaid and Medicare Services. Mathis, the chair of the Senate Human Resources Committee, and Ragan, Chair of the Senate Health and Human Services Appropriations Committee, wrote:
“No other state in the country has moved this quickly to convert its entire Medicaid population to managed care. It is now mid-September and the Iowa Department of Human Services (DHS) does not yet have signed contracts with the four managed care companies. How can they possibly develop adequate provider networks and transition 560,000 people to private plans in less than 4 months?”
Medicaid provides health care services to one out of five Iowans. The long term care of severely disabled adults and children makes up the bulk of Medicaid spending in Iowa. Medicaid also covers prenatal care to pregnant women, health insurance for low income children, and health care for low income seniors and others.
Medicaid is a state-federal partnership with the federal government providing over half the funding. The state of Iowa provides the rest and administers the program. Shortly after the 2014 election, the Branstad Administration announced it would hire private companies to manage the system. Iowa’s governor claimed the change would save $100 million a year, even as private companies were paid five times more in administrative costs, a total of $600 million a year.
“Governor Branstad wants to pay more and do less for Iowans in need,” said Senator Ragan. “In state after state, privatizing Medicaid has failed to save money. Instead, the public pays more money for less health care. We urge the Obama Administration to protect Iowa families from being denied health care in order to fatten corporate bank accounts.”
In the event that the Branstad plan is not completely rejected, the two legislators suggested 11 changes that would increase protections for Iowa families. They include a phase-in of changes rather than an abrupt change over on January 1, 2016; the establishment of a robust, independent case management system; and the creation of an independent appeals process for consumers and providers.
“In other states, Medicaid privatization has either not saved money or cost taxpayers more,” said Senator Mathis. “The most disturbing thing about Governor Branstad’s approach is that it does more and does it faster than any other state. This is a reckless, heartless way to provide health care to seriously ill people with nowhere else to turn.”
The Senators also expressed concern about media reports regarding charges of fraud or mismanagement by the four MCOs selected for Iowa that have resulted in hundreds of millions of dollars in fines.
In closing, the two senators summarized the case for stopping or making major changes to the Branstad proposal.
“Iowans are depending on you to make a decision that improves the health and well-being of our state and does not lead us down a path to disaster. Please do not approve this unwise and poorly developed plan.”
September 17, 2015, letter to federal Medicaid officials from Senators Ragan and Mathis
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