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Gov. Reynolds stands by privately run Medicaid

'I'm not going back,' governor vows, despite upheavals

The dome of the State Capitol building in Des Moines is shown on Tuesday, January 13, 2015. (Adam Wesley/The Gazette)
The dome of the State Capitol building in Des Moines is shown on Tuesday, January 13, 2015. (Adam Wesley/The Gazette)

BOONE — Gov. Kim Reynolds said Tuesday she is committed to a privately managed Medicaid system despite recent upheavals and calls from Democratic rivals to dump the approach.

“It’s not perfect. I’ve never said it was perfect,” the GOP governor told reporters during her weekly news conference. “I’m willing to put the time and the effort into making sure that Iowans get the care that they deserve in a managed and coordinated and more modern delivery system. I’m not going back.”

One of three companies initially hired to manage the program will exit this week after it and the state did not agree to terms for a new contract.

The departure of AmeriHealth Caritas Iowa has triggered missteps and confusion as state officials made different announcements on different days about what would happen to those previously managed by AmeriHealth.

Reynolds’ comments Tuesday came a day after Iowa Department of Human Services officials announced that Medicaid beneficiaries who had been bumped from AmeriHealth and chosen Amerigroup Iowa as their 2018 managed-care organization instead will actually be covered by a state program — a change that affects thousands of Iowans.

Iowa has signed new contracts with its remaining two Medicaid insurers — Amerigroup and UnitedHealthcare of the River Valley — and will seek a third to replace AmeriHealth.

Human Services Director Jerry Foxhoven said the state has instilled strong oversight expectations and is working with the insurers to achieve quality, cost-effective health care while ensuring sustainability to the program and the state budget.

Most of the former AmeriHealth clients will be switched to UnitedHealthcare, but the department plans to take charge of more than 9,000 Iowans who otherwise would be uncovered.

The governor said Human Services officials will provide coverage for them temporarily on a fee-for-service basis while providing Amerigroup a chance to build out its capacity and take on more people.

“They’ve taken some but they said right now that they don’t have the capacity to take all of them,” Reynolds said.

During Monday’s Iowa Democratic Party fall gala, the privatized Medicaid system was referred to as “Reynoldscare” and several of the party’s 2018 gubernatorial candidates called for scrapping the approach in favor of returning to a state-run program.

But the governor said the change was made in April 2016 because the state-run system was seeing average yearly cost increases of 10.7 percent that were not sustainable.

“My question back to them is: How are they going to pay for it? Are they not going to fund education? Are they not going to fund health care? Where are they going to move the dollars around if their answer is to go back to a program that had all kinds of problems with it also?” Reynolds asked. “People have short memories.”

During his fiscal 2019 budget presentation to the governor Tuesday, Foxhoven gave a positive view of the agency’s performance in child protection, regional delivery of mental health services and welfare-to-work programs without delving into a request to boost state funding by nearly $100 million, most of it going to Medicaid areas.

l Comments: (515) 243-7220; rod.boshart@thegazette.com

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