2019 LEGISLATIVE SESSION

Reynolds promises smooth transition for Iowa's Medicaid members

Gov. Kim Reynolds speaks during the Condition of the State address in the House Chamber at the Iowa State Capitol in Des Moines on Jan. 15, 2019. (The Gazette)
Gov. Kim Reynolds speaks during the Condition of the State address in the House Chamber at the Iowa State Capitol in Des Moines on Jan. 15, 2019. (The Gazette)
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DES MOINES — Gov. Kim Reynolds pledged Wednesday to provide a smooth transition for Medicaid enrollees in Iowa affected by UnitedHealthcare of the River Valley’s planned pull out.

But she resisted renewed calls by critics to revamp the privatized managed-care system they said is heading for a new round of “chaos and anxiety.”

Reynolds told reporters Amerigroup Iowa and Iowa Total Care will be in a position to absorb the 425,000 Iowa Medicaid members who will be losing their current insurance provider when UnitedHealthcare ends its contract later this year.

Amerigroup Iowa is currently providing Medicaid coverage for Iowa’s poor and disabled. Iowa Total Care — owned by St. Louis-based Centene — is set to join July 1.

“We’re doing everything that we can to make sure that we have a smooth transition. The reallocation was happening anyway because we were bringing Iowa Total Care in,” the governor said.

Impacted individuals will receive notices that they will be reassigned and will have 90 days to “self-select” if they want to go with a different insurance company.

“We’re focused on making sure that we’re ready to go, that the transition is smooth,” she said.

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She added both Amerigroup and Iowa Total Care are committed to providing services in Iowa and the state is “working to make sure that Iowans get the coverage that they deserve with as little disruption as possible.”

In announcing the decision to leave Iowa, officials for the departing managed-care organization contended that the loss of millions of dollars due to underfunding of Medicaid put long-term sustainability in question.

But state officials maintain Edina, Minn.-based UnitedHealthcare decided it would depart the program because it did not want to be held accountable to Iowa’s standards.

Legislative Democrats who have been critical of a privately managed Medicaid system they say was implemented unilaterally by then-Gov. Terry Branstad without legislative input is undergoing its second upheaval in two and a half years because it’s flawed and needs to be revamped to return some of Iowa’s most vulnerable disabled citizens to a fee-for-service system under state direction.

“This is certainly a time of chaos and anxiety for many of our constituents right now with the announcement that UnitedHealthcare will be leaving the state of Iowa,” said Sen. Pam Jochum, D-Dubuque. “This is the time to take action. It is now. We can do better.”

Democrats took to the Iowa Senate floor Wednesday to call on Reynolds to convene a public process of getting input from Medicaid recipients, provider groups and others on how best to redesign the Medicaid service delivery system

“We have to come together and fix this mess,” said Senate Democratic Leader Janet Petersen of Des Moines.

“It’s going to be really bumpy. It’s going to be another very bumpy ride and people don’t deserve that, Iowans don’t deserve that,” said Sen. Liz Mathis, D-Hiawatha, who pointed to legislation introduced this session that proposed ways to improve the current system.

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“I think it’s time to hit the reset button. It’s really time to hit the reset button. We have an opportunity right now to fix a broken system.”

Sen. Mariannette Miller-Meeks, R-Ottumwa, conceded to her Senate colleagues that “no doubt that our foray into managed care has been difficult and rocky,” but she noted the rollout of the Affordable Care Act at the federal level was fraught with problems for three years until things stabilized.

“It will take time. Give this a chance,” she said. “It’s hard to be patient, but give it a chance because I think our governor took a courageous stand in standing up to an insurance company who wanted to waive and ask demands that were unmet.”

Reynolds said the state’s old fee-for-service model was not sustainable and the infrastructure no longer exists to convert back coverage for Iowa’s disabled and most-vulnerable Medicaid recipients.

l Comments: (515) 243-7220; rod.boshart@thegazette.com

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