Government

Iowa Senate leader: March 1 Medicaid transition may not occur

Feds must give OK for switch

Enrollment information for managed-care organizations in Iowa's Medicaid privatization plan, photographed in Cedar Rapids on Friday, Dec. 18, 2015. (Liz Martin/The Gazette)
Enrollment information for managed-care organizations in Iowa's Medicaid privatization plan, photographed in Cedar Rapids on Friday, Dec. 18, 2015. (Liz Martin/The Gazette)

JOHNSTON — Sixteen days before private companies are to begin delivering managed care to 560,000 Iowans on Medicaid, a key legislative leader said she’s “not convinced it’s a done deal yet.”

“I’m not willing to concede to it yet,” Senate President Pam Jochum, D-Dubuque, said Friday about the privatization of the management of the state’s Medicaid services. Her remarks came during the taping of Iowa Public Television’s “Iowa Press.”

Jochum isn’t convinced that Gov. Terry Branstad’s plan to transition the state’s $5 billion Medicaid program to out-of-state managed-care companies will happen March 1. That’s two months later than the Republican governor planned for the switch because the federal Centers for Medicare and Medicaid Services, which still must approve the plan, delayed the start from Jan. 1, citing readiness concerns, including an inadequate provider network and communication problems between the state and Medicaid providers and beneficiaries.

In fact, Jochum floor-managed Senate passage, 29-19, of legislation Thursday to halt the transition. She argued, in part, that of the 16 issues the federal centers told Iowa to address, only one has been resolved.

However, House Human Resources Committee Chairman Dave Heaton, R-Mount Pleasant, was more optimistic about the March 1 transition and the potential benefits of managed care.

Like the goals of the Affordable Care Act, he said, the goal is to get low-income Iowans covered so they can access health care without going to emergency rooms.

Medicaid recipients will be moved from a fee-for-service system that was “just curing people’s ills, to a whole culture of wellness,” Heaton said. “The secret to lowering health care costs is to move people to wellness, take on chronic disease and then, at the same time, offer them the very best health care for these people that we possibly can.”

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Another goal of the transition is to contain costs, which have been consuming a growing portion of the state budget.

Jochum, however, is not convinced the plan would yield real savings despite lawmakers building the projected $111 million in savings into their budget plans.

Heaton believes the changes will result in savings and improved services for Iowans with disabilities. For example, he said, he expects fewer Iowans will be living in residential institutions, where costs can be as much as $1,000 a day. Instead, they will be in community-based residences that cost about a quarter of that.

Heaton also believes services such as home health care and adult day care will allow older Iowans to remain in their homes longer “and that’s where the rewards are.”

The Medicaid transition will not affect recipients living in nursing homes until 2017.

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