Letter: Medicaid is not a private health plan

Marsha Simon

Iowa’s evaluation of Gov. Terry Branstad’s Medicaid expansion finds that new Medicaid patients recently added to the program report poorer health than similar patients eligible before the expansion.

This group of poor, single adults report worse physical and mental health, multiple physical ailments and functional limitations when compared to poor families already in Medicaid. Not surprisingly, these individuals also report difficulty finding transportation to their doctor.

Despite poor health and their stated need for transportation, Iowa is denying these patients rides to medical appointments because Gov. Branstad wants them to have a “commercial-like benefit plan.” Iowa should stop trying to make their Medicaid program look like a private health plan and offer Medicaid benefits that match health care needs.

A recent paper by the Community Transportation Association of America used Medicaid transportation data to show that it is the chronically ill who have the greatest need for medical transportation, especially those needing kidney dialysis. Other than making privatization a goal in itself, there is no rationale for Gov. Branstad to continue to deny sick patients the means to access routine medical care. Benefits ought to be designed around patient need, not whether a patient fits into an arbitrary category.

Marsha Simon

President, MJ Simon and Co.

Former health policy staffer to former Sen. Tom Harkin

Washington, D.C.

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