Keep politics out of Medicaid debate

The political theater surrounding Gov. Terry Branstad's drive to turn Iowa's Medicaid program over to a trio of private managed care companies kicked into high gear this week.

Democrats who run the Iowa Senate approved legislation intended to block the transition to private managed care, now set for March 1. The legislation stands virtually no chance of being debated by the Republican-controlled House or signed by the governor. But at least one GOP lawmaker, Sen. David Johnson, R-Ocheyedan, publicly expressed misgiving about privatization's swift pace. He was one of three Republicans joined Democrats in voting for the bill.

Former Democratic Gov. Chet Culver embarked on a series of town hall meetings, including sessions in Coralville and Cedar Rapids, for Medicaid clients, family members and providers to air concerns about the transition. Culver heard many stories from Iowans who still have not received the information they need to navigate the process.

Certainly, Democrats are seeking to make political hay. But they're also channeling the frustrations of thousands of Iowans with strong misgivings about the move to managed care, Iowans the governor did not consult before he made his unilateral decision last year to transform the program.

So it's disappointing that instead of meeting those misgivings head on, the governor switched into campaign mode. He condemned Culver's stewardship of Medicaid, echoing campaign themes from back in 2010. An advocacy group led by Branstad's former spokesman also geared up to refute Culver.

On Wednesday, the governor's office announced that 'Iowa's Medicaid Modernization plan will improve quality and access for Medicaid patients,” pointing to the testimony of an actuary who told lawmakers that his experience in other states points to improvements through managed care.

But details are lacking, and governor's announcement comes more than a month after the administration's original transition date. The federal Centers for Medicare and Medicaid Services smartly stepped in back in December to delay transition two months.

The issue here is not who wins the political fight. The issue is that Iowans who depend on Medicaid and who pay taxes to support it still lack a fundamental understanding and confidence in the transition. The governor and his allies argue critics are afraid of change. But it's clear much of the fear has been spawned by the pace of that change demanded by Branstad.

We understand the need to control rising Medicaid costs in tight budget times. Managed care holds promise. But this rushed transition seems more concerned more with making next year's budget balance than helping Iowans in need find their way through difficult change.

Branstad, as he did before Jan. 1, insists the state is ready. The federal government disagreed. Based on the continued outcry by Iowans, we urge another delay.

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