Letter: Medicaid privatization needs oversight

Those in favor of handing over Medicaid management to private companies say it will 1) save the state money 2) without sacrificing quality. This letter offers a critical look at these assumptions and advocates for the establishment of the oversight committee outlined in Senate File 2213.

1) Projected Savings. Kansas contracted two of the same companies to manage Medicaid privatization and this excerpt from a Hays (Kan.) Daily News editorial (May 2, 2015) describes unfavorable outcomes: 'UnitedHealthcare and Amerigroup, the firms hired in hopes of reducing costs for Kansas, reported they continue to lose money … It appears all we can do is wonder why savings have not materialized, as there is little oversight of KanCare.” Iowa legislators need to be proactive in establishing oversight to avoid a situation in which we are left helpless and confused.

2) Quality Care. Measuring the quality of care delivered by these companies depends on their cooperation and transparency. An accountability investigation by St. Louis University School of Law described a 'hostile response” from UnitedHealthcare, which refused to share information about the provider network (a key component of accessing care) without a subpoena. Without oversight, we won't know if our money is being spent on delivering the services promised, or if care is being limited to maximize profits.

As we hurtle toward the privatization of Medicaid services, we need to hold these companies accountable for their care management and financial performances. Removing government completely means handing over care of Iowans - some with complex, long-term health needs - to companies who prioritize quarterly profits.

Tessa Heeren

Iowa City