Myths about Medicaid privatization in Iowa

As Iowa's 118 community hospitals and 71,000 hospital employees work daily to bring healing and wellness to all Iowans, the state's reckless rush toward privatization of the Medicaid program has been a source of extreme concern. Most concerning are the myths about privatization perpetuated by our own governor as he tries to promote what is simply a bad idea for Iowa and, especially, for 560,000 vulnerable Iowans who depend on Medicaid.

On behalf of those Iowans and the health care professionals who care for them, it's time that all of Iowa sees these myths for what they are: misleading half-truths that cannot hide the failures of this ill-conceived plan.

Myth: The federal government held Iowa to a higher standard when it forced the state to delay its plan.

Fact: The governor and his staff knew exactly what was needed to satisfy federal officials and, with any exercise of due diligence, they should have also realized it would be impossible to make this wholesale transition in only a year. No other state has ever privatized even part of its Medicaid program in such a tight time frame, let alone the entire program, as the governor is seeking to do.

It was obvious to everyone, particularly among frustrated Medicaid beneficiaries, that the state was not ready, but Governor Branstad chose to ignore them, the people who provide their health care and other state leaders. Federal officials did what they were supposed to do: protect beneficiaries and ensure program integrity.

Myth: Medicaid privatization is the only option for coordinated, accountable care.

Fact: With the full knowledge and endorsement of Governor Branstad, the state already supports alternatives through the Medicaid State Innovation Model, Integrated Health Homes and Accountable Care Organizations - and as far as reducing cost and improving efficiency, they are working. The state and hospitals have put cooperative effort into these programs and they have shown more savings in the past five years than private managed care for Medicaid has demonstrated in 30 years of so-called 'innovation”. Then again, there is nothing innovative about denying and delaying care.

The bottom line is Iowa already has one of the most efficient Medicaid systems in the nation and the state and health care providers have been working, hand-in-hand, to make it even better. Privatization will simply interject a very expensive middleman who will extract millions of dollars to meet corporate goals while adding no value to the system.

Myth: Iowans will support clean water, strong public education or a community-based, efficient and patient-oriented Medicaid program, but not all three.

Fact: Iowans can and do support all three and the path hospitals and other health providers desire to take will further sustain Medicaid and other widely-held priorities. The people of this state would rightfully reject wholesale privatization of the public school system or water resources, so it's no surprise that nearly eight out of 10 Iowans oppose privatizing health care coverage for a half million highly vulnerable citizens. Knowing that, Governor Branstad's administration fired its plan through the Capitol with no legislative debate and then, with the throttle firmly planted to the floor, pretended to take input from a predictably skeptical public.

As of today, nothing has been done to assuage that skepticism, which is why IHA, along with thousands of health care professionals and even more everyday Iowans, continues to oppose this untenable, unnecessary plan that puts the health of impoverished, disabled and elderly Iowans at risk.

Health care providers across the state know we can do better. In fact, we already are.

' Kirk Norris is president and CEO of the Iowa Hospital Association. Comments: norrisk@ihaonline.org