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Iowa politicians scuffle over Medicaid plan; former Gov. Culver weighs in

Republican signs on to delay start date

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As Iowa moves closer to the March 1 transition date that would shift the state’s $5 billion Medicaid program to three out-of-state managed-care companies, politicians — both in and out of office — weighed in on ways to stop the move.

Gov. Terry Branstad announced plans in early 2015 to move the state’s Medicaid program, which cares for 560,000 Iowans, over to managed care. The state initially aimed to make the transition on Jan. 1.

But the federal Centers for Medicare and Medicaid Services (CMS) — which still must approve the plan — delayed the move to March 1, citing an inadequate provider network and other concerns.

On Monday, U.S. Rep. Dave Loebsack, a Democrat, released a letter he’d written to President Barack Obama, asking him to deny the state’s request for a CMS approval. Loebsack, who also has written letters to Branstad and CMS Director Andy Slavitt, said he has significant concerns regarding the transition.

“I have spoken personally to many Iowans who would be impacted by this change, including parents of children with disabilities,” Loebsack wrote. “Each day, these parents are scared that their children will not be able to access the life-sustaining therapies they need once the transition is made.”

On Tuesday, former Gov. Chet Culver, also a Democrat, will hold a series of town-hall meetings to speak with advocates and Medicaid members about the transition.

Culver told The Gazette on Monday that he decided to get involved in the conversation after hearing and reading about some of the problems facing the state’s plan, including the CMS-imposed delay, an attempt by Iowa hospitals to delay the transition through an injunction, and problems in the bidding process that since have resulted in WellCare of Iowa’s contract being tossed out.

“As I’ve watched this unfold, like a lot of people I became more and more worried,” he said.

Culver said his involvement has “nothing to do with politics” or any future plans to run for office, but he wants ensure sure “bad policy is fixed and addressed.”

Culver said he also intends to hold meetings in the Quad Cities and Sioux City.

Meanwhile, Sen. David Johnson, R-Ocheyedan, gave his support to an effort to halt the transition plan. A bill that passed through two committees Monday in the Democrat-controlled Senate would nullify the state contracts with those managed-care companies.

“I just believe that at the very least we need to slow the process down,” Johnson said. “... There’s no point in us arguing on political ideologies about this. We need to look at exactly what’s going on here and remember the patients and the clients come first.”

The bill likely could pass the full Iowa Senate on the strength of a Democratic majority even without Johnson’s support. But it probably faces a short shelf life in the Republican-controlled Iowa House.

Rep. Dave Heaton, who chairs the House health care budget committee, gave a passionate defense of Gov. Branstad’s plan.

“I just can’t agree on a delay. I think there’s just too much at stake here,” Heaton said.

House Speaker Linda Upmeyer, R-Clear Lake, said late last week that she does not expect the bill will receive a hearing in the House.

Branstad, during his weekly news conference on Monday, said he was disappointed that Culver and Senate Democrats were turning the transition into a “partisan political issue.”

He has cited increasing Medicaid costs as a reason behind the move, adding he believes the transition to managed care can save millions of dollars in the first six months.

“I would point out that when (Lieutenant Gov. Kim Reynolds) and I were elected, Culver had used $440 million in one-time money for Medicaid,” he said. “The Medicaid program was in jeopardy because there were not ongoing funds being used to sustain it. We dug out of that big hole he created.”

Branstad said for Culver to now join Senate Democrats to “torpedo a thoughtful” approach is “outrageous.”

Gazette Des Moines bureau reporter James Q. Lynch contributed to this story.

Culver in the Corridor Tuesday

• What: Former Gov. Chet Culver will hold two town-hall-style meetings in the Corridor to meet with those affected by the state’s shift to Medicaid managed care. The sessions are open to the public.

• When: 10 to 11:30 a.m. Tuesday

• Where: Schwab Auditorium, Coralville Public Library, 1401 Fifth St., Coralville

• When: 2 to 3:30 p.m. Tuesday

• Where: Whipple Auditorium, Cedar Rapids Public Library, 450 Fifth Ave.

• To register: Go to http://smgs.us/3k6h.

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