DES MOINES — Gov. Kim Reynolds on Wednesday defended her administration’s efforts to contain costs while maintaining health services under privately managed Medicaid, dismissing as just political a Democratic senator’s call for a state auditor’s analysis of the savings.
“We moving in the right direction,” said Reynolds, who previously admitted that mistakes were made in Iowa’s switch from a fee-for-service approach to privatized Medicaid starting in April 2016. She noted Wednesday that the state has “the right leadership in place” and now has a third managed care organization lined up to strengthen the system.
“The bottom line is we’re focused on Iowans and making sure that vulnerable Iowans have access to the services that they deserve,” the GOP governor told reporters. “This is pro-active, it’s patient-centered and we’re going to continue to work on it every single day and we welcome (critics) to be a part of it. But let’s sit down and see how we can work together to really put Iowans first and to keep the program moving forward.”
Reynolds’ comments came one day after state Sen. Pam Jochum, D-Dubuque, a critic of Iowa’s move to privatization, asked that State Auditor Mary Mosiman look into the state Medicaid program and the managed-care organizations running it.
The request came after cost-savings estimates released by a state department differed from previous estimates — savings claims that Jochum called “suspect.”
In her letter, Jochum requested the auditor’s office seek documentation from the Iowa Department of Human Services and the private companies that administer Medicaid coverage “to determine if Iowans are really saving money by paying out of state, for-profit insurance companies to care for our most vulnerable.”
The auditor’s office has declined to comment on Jochum’s request, other than to confirm it is under review.
Human Services, which oversees the state Medicaid program, released a savings estimate last week indicating the state has saved a “projected annual range” of $140.9 million. The department did not clarify how officials had calculated those numbers.
The $140.9 million figure is much higher than the estimates released in the department’s last quarterly report published in December. That report stated Iowa was estimated to save $47.1 million for the current budget year, which ends in June. In addition, this estimate also differed from the initial figures released before Iowa’s Medicaid program was privatized, when then-Gov. Terry Branstad stated Iowa would be saving up to $232 million by this budget year.
Reynolds defended the department’s numbers, telling reporters at her weekly news conference that state Medicaid Director Michael Randol would sit down with media to walk through the projections, but cautioned “it’s a complicated matter” to understand.
Privatization of Medicaid was touted as a cost-saving measure before its implementation in 2016, when three private insurance companies took over. One of the private companied dropped out, but is set to be replaced next year. The $5 billion program provides coverage for nearly 600,000 poor, disabled and elderly Iowans.
Critics have said the shift created serious challenges, including cuts to services and a backlog of unpaid claims.
Other topics Wednesday at the news conference:
• Reynolds said she and her husband, Kevin, would release at least five years of her income-tax returns and make other financial disclosures at some point. She said it will be up to the other candidates for governor to decide if they plan to do likewise.
One day earlier, Democratic gubernatorial candidate Fred Hubbell, a retired Des Moines businessman, said he would be willing to disclose his tax returns and make other pertinent financial disclosures if other Democrats and Reynolds do as well.
• Reynolds said she was fine with the Republican Party of Iowa’s decision to accept a $522,000 contribution from former Senate Majority Leader Bill Dix’s campaign. Dix, a Shell Rock Republican who resigned in March after a video surfaced of him kissing a female lobbyist, donated the money in his Friends of Dix campaign account to the party, according to the latest campaign finance disclosure reports.
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“I think that what they did was an appropriate decision so I’m fine with what the Republican Party did,” the governor said. Under Iowa law, the money could have been given to political and charitable groups, returned to donors or sent to the state general fund.