Democrats seek to end Medicaid privatization

DES MOINES - Legislative Democrats on Thursday declared Gov. Terry Branstad's plan to hire private companies to manage Iowa's $5 billion Medicaid program 'a disaster” and planned to run legislation next week to 'pull the plug” on privatization in favor of the state-run system.

'This thing's a mess right now. The rollout has been horrible. It's a disaster,” Senate Majority Leader Mike Gronstal, D-Council Bluffs, said of Branstad's effort to bring in private managers to oversee health options for a more-efficient Medicaid program that serves 560,000 Iowans.

However, Branstad aides said the GOP governor is moving ahead with plans to implement his Medicaid modernization March 1 and House Speaker Linda Upmeyer, R-Clear Lake, said she did not expect the Republican-run Iowa House would join Democrats in obstructing a change designed to improve health outcomes for recipients and contain rising health care costs better than the current approach.

'I'm certainly not interested in passing any bill that faces a certain veto, so that's probably not something we'll do,” said Upmeyer, who expressed disappointment that opponents have been delaying and 'sabotaging the whole idea simply to protect the status quo.”

She also noted that ending the effort 'totally blows up their budget” because up to $55 million in savings was built into this fiscal year's spending plan.

Senate President Pam Jochum, D-Dubuque, said majority Senate Democrats plan to work next week on legislation that would halt the governor's 'unilateral decision to privatize Iowa's Medicaid program” because Iowans are telling them the plan is failing amid confusion and frustration with a changeover - already once delayed - that is slated to take place March 1.

'Gov. Branstad tried to do too much, too fast. As a result, he has failed to protect vulnerable Iowans,” said Jochum, who said a subcommittee on Monday will take up the 'Health Care Protection Act” (Senate Study Bill 3081) - a bill which directs the Iowa Department of Human Services to immediately give notice of termination to the three private out-of-state managed care companies and directs state agencies to continue efforts to improve patient outcomes, increase access to care and make the public management of Medicaid more efficient.

'This common-sense legislation is necessary because Iowa still isn't ready - even after a 60-day delay - to implement a privatized Medicaid system operated by for-profit, out-of-state companies,” Jochum told a Statehouse news conference.

Officials with the federal Centers for Medicare and Medicaid Services (CMS) delayed the planned Jan. 1 implementation of the switch to a privately managed Medicaid system in Iowa until March 1 to give DHS officials and private companies more time to make changes and correct deficiencies to ensure the health and well-being Iowans receiving Medicaid services.

However, Jochum, who has an adult developmentally disabled daughter enrolled in Medicaid, and Rep. Lisa Heddens, D-Ames, said Iowans continue to express concerns over a failure to establish adequate provider networks, disruptions of long-standing patient-provider relationships, diminished quality and access to health care services, and inadequate communication with patients and providers as March 1 approaches.

'The problems are widespread,” said Heddens, a House human services committee and budget subcommittee member who cares for an adult dependent with an intellectual disability who receives Medicaid, 'it's just a huge mess that, in my opinion, need to go away at the very least.”

Branstad spokesman Ben Hammes said the administration will continue to move forward in securing CMS' approval for implementing the privately managed Medicaid plan on March 1.

'Senate Democrats have played politics with Medicaid from the very beginning. We hope that their bill also includes a Medicaid plan that improves access and coordination while bringing stability to the state budget,” he said.

'We know that managed care means more doctors for Medicaid patients,” Hammes added in a statement.

'We know that managed care means better access for those patients to doctors, and we know that managed care means curbing the exponential cost growth associated with Medicaid,” the governor's spokesman added, '39 other states can't be wrong.”

Senate Minority Leader Bill Dix, R-Shell Rock, said legislative Democrats 'can't have it both ways” by seeking to halt Medicaid privatization plan while building the cost-savings assumptions into their spending targets.

'They are not being honest with Iowans,” the Senate GOP leader said.