Iowa Dems ask Obama to weigh in on Medicaid transition

Iowa's 26 Democratic senators on Wednesday wrote a letter to President Barack Obama expressing their 'heartfelt concerns” regarding Gov. Terry Branstad's decision to move the state's $5 billion Medicaid program over to a managed-care system on March 1.

The letter asks for the Centers for Medicare and Medicaid Services, the federal agency that must still approve the transition, to instead deny the application.

'As an alternative, we are asking for strong consideration of directing Iowa to continue to improve patient outcomes, increase access to care, and achieve delivery efficiencies through the existing public management of Medicaid and the work of the State Innovation Model (SIM) grant; Accountable Care Organization (ACO) development; and integrated health homes,” the senators wrote.

Branstad announced the plan to move the Medicaid program and its 560,000 beneficiaries over to managed care in early 2015. In October 2015, the state signed contracts with Amerigroup Iowa, AmeriHealth Caritas Iowa, UnitedHealthcare of the River Valley and WellCare of Iowa.

However, since that original announcement, a state arbiter ruled to throw out WellCare's contract, citing the company's failure to disclose information about millions of dollars in fines. WellCare maintains it gave the state that information and is appealing the decision.

Meanwhile, the state is in the midst of reassigning the more than 130,000 individuals who were on the WellCare plan. Iowa DHS said Medicaid recipients should receive their new assignments the first week of February.

The letter also discussed potential readiness problems, including inadequate provider networks and continued confusion regarding communications from the Iowa Department of Human Services.

'For example, less than one-half of the current providers have signed with all three MCOs. In addition, just last week WellCare's contract was terminated, leaving the 125,000 individuals assigned to them at square one. We hear countless complaints from our constituents daily.”

According to Iowa DHS, about 85,000 contracts have been signed - 75 percent of Iowa's nearly 30,000 Medicaid providers have agreed to at least one contract and 45 percent have signed contracts with all three remaining managed-care organizations.