Why I voted to stop Medicaid privatization in Iowa

This week I cast the most important health care vote of my service in the Iowa Senate.

I voted to shut down Gov. Terry Branstad's push to privatize Iowa Medicaid.

Governor Branstad says that privatizing Medicaid will save money and will not deny Iowans essential health care. He is wrong on both counts.

Let's start with Medicaid costs.

Much of Iowa's increased Medicaid costs have nothing to do with higher health care costs. Medicaid is funded jointly by the federal government and the state of Iowa. Since 2012, the federal share has dropped due to Iowa's greater economic strength compared to other states. The shrinking federal share increased Iowa's annual Medicaid costs by $266 million.

In 2013, the Iowa Legislature picked up the counties' share of Medicaid mental health services. This year, our state's annual Medicaid cost was $324 million larger due to that decision. Neither of these increases had anything to do with how Medicaid services are provided.

In fact, according to the nonpartisan Legislative Service Bureau, our costs per Medicaid patient are low and relatively constant compared to other states.

Here's the heart of this issue.

Most of Medicaid goes to fund Iowa's health care safety net. Over 70 percent of Medicaid dollars go to caring for about quarter of the Iowans in the program. They are the elderly and people living with disabilities.

If your parent, your spouse, or your child has a severe disability, the chances are that they will be on Medicaid. When things go very, very wrong, Medicaid provides the care that would otherwise bankrupt most Iowa families.

If the Branstad/Reynolds Administration listened to Iowans, they would know the importance of Medicaid.

If they were asked, parents of children with autism would tell Governor Branstad that it is not at all unusual for their kids to have several medical conditions and to see more than one physician.

Telling people to eat more vegetables will not significantly lower the cost of caring for people living with autism or cerebral palsy or dementia or any other challenging health care burden.

Putting Wall Street firms in between Iowa families and their Iowa health care providers won't save money either and it won't improve health care.

What it will do is take several hundred million dollars each year out of Iowa's Medicaid budget and give it to out-of-state corporations in the form of guaranteed administrative fees and profits.

There are two basic ways the managed care companies will cut costs. One is by denying health care to Iowans, especially the Iowans whose health care is the most threatened and the most expensive. The second is by not paying Iowa providers the full cost of the health care they provide.

Medicaid helps us all sleep better at night. By helping those in need, we also make sure help will be there if we need it ourselves.

Senator David Johnson, a Republican from northwest Iowa, is the leading Republican on the Human Resources Committee. On Monday, he voted to end Medicaid privatization. He said he did so after talking with doctors and families in his Senate district.

This week, the Iowa Senate cast a key vote that will affect the health care safety net every Iowa family depends on.

• Joe Bolkcom, D-Iowa City, is Iowa Senate majority whip and chairman of the Senate Ways and Means Committee. Comments: joe.bolkcom@legis.iowa.gov