Guest Columnists

A second chance to fix Medicaid in Iowa

Dave Jacoby, Iowa House 30 2008
Dave Jacoby, Iowa House 30 2008

Sometimes in life you don’t get a second chance. When a poorly initiated plan to change the course of Medicaid results in people dying, then even a governor who pays less in state taxes than the average Iowan (which accounts for one-third of the support for Medicaid) needs to make one of two choices: Make it right with a bipartisan committee to right this ship or call for a special session.

I have worked with many individuals and their families in navigating the new system — if it can really be called a system. I’ve witnessed tears and fears from those dealing with a lack of service that causes unnecessary stress and makes planning difficult for loved ones. But when a case came to me in real time, late one Friday afternoon, my perspective changed dramatically.

I received a call from a loved one whose partner was dying and who probably had only days left to live. Their Managed Care Organization had blocked his transfer to hospice. It would take a minimum of seven days to make a correction in their “system.” Regardless of her wishes, the wishes of the family, the advice from doctors and nurses and, most importantly, the patient’s wishes, the MCO failed to grant the transfer.

This gentleman was 68 years old, on Medicare and needed Medicaid certification to move to a facility where he and his family could say goodbye. A man who worked his entire life without asking anyone for anything could not get the transfer he desperately wanted. This was his payback.

Never mind that in a time of astronomical health care costs that the transfer not only would have honored his wishes, it would have saved thousands in taxpayer (and his) dollars. This was not a case of, “just wait a couple of weeks and we will get it right.”

It is time for the governor and house Republicans to shoulder personal responsibility for the Medicaid mess. I am willing to work with you to do this the right way. A special session with a bipartisan effort can make this work.

We have a second chance to make it work. The family that I worked with this past weekend did not get a second chance.


• Dave Jacoby, of Coralville, represents House District 74. Comments:



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