Robust oversight of Medicaid is needed

The state's second quarterly oversight meeting of Medicaid modernization showed the need: Iowa lawmakers must work to provide more robust oversight of the system.

Three out-of-state, private providers manage the public health care system, which delivers essential services to more than 600,000 state residents and absorbs more than $5 billion taxpayer dollars. Effective and cost-efficient management must be a bipartisan priority. It's both a moral and economic imperative. All Iowans benefit from a system that delivers quality service at the lowest cost.

But such a system cannot and will not manifest on its own.

Iowa's public health care system, formerly run by state government, is now administered by companies that naturally view profits and stock values as a top priority. While understandable, unchecked private-sector priorities have the potential to run counter to taxpayer and state interests.

As we've written before, ensuring the state's most vulnerable residents are able to access the medical help they need and clear understanding of how taxpayer funds are spent requires public discussion, something representatives of the managed care organizations have been reluctant to embrace.

The second report on the Medicaid switch was compiled by officials at the Iowa Department of Human Services and reviewed by lawmakers this past week. The document is similar to the first report in that it provides several sets of numbers, but little 'big picture” clarity about whether modernized Medicaid is operating as intended.

Will the companies, all facing significant losses in these first months, seek additional rate increases? Their representatives refused to say, noting a preference for private negotiations.

But Medicaid is a publicly-financed health care plan. Iowans have a vested interest and rightfully expect their elected officials to provide for robust and meaningful oversight.

The time for debate over whether or not the Branstad administration was right to hand Iowa Medicaid to three out-of-state providers has passed. Privatization is a done deal.

But that doesn't mean the books should be closed. Just the opposite. Privatization of the system makes the need for public oversight greater now than ever before.

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