Letter: Questions remain in Medicaid program

Some interesting conclusions can be drawn as we consider the privatization of Iowa's Medicaid program. It seems the state paid a company to draw up cost estimates which were provided to the MCOs. This was to inform their decision about participation. Based upon those figures, the MCOs were led to believe this might be a profitable endeavor for them. However, since the rollout, the accuracy of those figures has come under further scrutiny.

Neither the governor, nor Mikki Stier, nor Chuck Palmer were able/willing to respond to inquiries about how this shift might impact Medicaid recipients and providers. The providers begged for information about what their reimbursement rates would be and could not get an answer. Recipients wondered about how their future health care provision could be ensured and were advised to 'trust us.”

We are not even a year into this contract signed by the state with the MCOs and all three are calling the arrangement 'unsustainable.” DHS's claim the rates paid to the MCOs will not be increased only adds more uncertainty for providers and the people those companies serve. What is to prevent the MCOs from simply pulling out of our state? Is there a contingency plan in place, should that occur?

What might have happened had the cost estimates been more accurate? What might have happened had the process been more transparent? More importantly, what is going to happen now?

Mickey Dunn

Center Point