Democrats hope to keep managed care in the spotlight

With Republicans in control of the Statehouse come January, there will be a new set of legislative priorities. But Senate Democrats plan to keep Medicaid managed-care oversight at the forefront of the conversations.

The state handed over its nearly $5 billion Medicaid program to three private health insurers on April 1. The Senate Democrats have been vocal opponents of the transition - holding listening posts around the state in the lead up to and after the transition, and calling for delays and pushing for oversight.

The then-Democrat-controlled Iowa Senate passed an expansive oversight bill in early March that included provisions to enhance the role and responsibilities of the Health Policy Oversight Committee, execute a comprehensive review of program integrity and create a special fund to finance system improvements and support for recipients.

The bill failed to make it through the Iowa House, however legislators were able to reach a compromise and appropriate oversight funding through the health and human services budget.

The oversight includes additional funds for a managed-care ombudsman, external quality reports and expanded duties for the Medical Assistance Advisory Council, among other items.

'We still believe oversight is a crucial part so that vulnerable Iowans do not fall through the cracks,” said Senate President Pam Jochum, D-Dubuque. 'We will still have meetings and hold (Gov. Terry Branstad) and the MCOs (managed-care organizations) accountable.”

But, Jochum said, it's more important than ever that Medicaid enrollees and their family advocate for strong oversight.

That's because the change in power means Sen. Liz Mathis, D-Cedar Rapids, no longer will chair the Senate Human Resources committee and Sen. Amanda Ragan, D-Mason City, no longer will co-chair the Health Policy Oversight Committee.

During the last legislative session, Mathis held multiple hearings on the transition - calling Department of Human Services officials and the heads of the insurance companies to testify - while Ragan helped lead oversight meetings last year and this past August.

'I'm concerned,” Ragan said.

But she expects parties to work together to ask the necessary questions to ensure providers and consumers are protected.

A second oversight meeting will take place in December.