Clear Iowa’s Medicaid waiver waitlist

As parents of an adult son with a rare form of epilepsy and intellectual and developmental disabilities, we have learned how to weather the ups and downs of Iowa’s Medicaid program over the years. Like most stories you have heard since Iowa abruptly moved to the managed Medicaid system otherwise known as Iowa’s MCOs, we experienced some bumps along the road. Everyone agrees the transition was too much, too fast, however now that Iowa has several years under its belt, the promises of the newly created program are still yet to be realized. Iowa is not saving money; patients are not getting better care and fewer providers are available to Iowa’s most fragile residents. Many served by the MCOs have felt like they have been through a health care tornado.

This past summer the state announced it would be issuing a request for proposals with the goal of adding MCOs. We issue a word of caution and request the state look long and hard at the companies who want to come provide services to Iowans. We suggest the state look at the track record of these companies in other states, call their colleagues to see what they are like to work with and how they deliver services, and find companies who specialize in serving those with complex needs.

Most have come to realize that the MCOs are not going away, however Iowa can do better. We urge the newly appointed Medicaid Director to move Iowa’s MCO program to the next level and deliver on the original promises and put patients first.

Also, with surplus funds in the state budget, there is no better time than now to provide the needed funding to alleviate the long waitlist for Medicaid Home and Community-Based Services (HCBS) waivers, which stood at a jaw-dropping 16,888 Iowans, children and adults, as of August 2021. These waivers provide a variety of services to individuals with disabilities such as adult day care, respite and supported community living, to name just a few. They save money by meeting the needs of citizens in their homes and communities and by keeping them out of institutions.

Past bipartisan efforts have been successful in clearing the waiting lists. We ask lawmakers to find the political courage and moral fortitude to work together to clear the waiver waitlists before cutting taxes and thus reducing millions of dollars from state revenue necessary to meet the needs of the most vulnerable.

Sara and Dale Todd live in Cedar Rapids.

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