State Auditor to review Iowa Medicaid program

Mary Mosiman

State auditor
Mary Mosiman State auditor

Iowa’s State Auditor said she will push forward with a review of the state’s Medicaid system after a Democratic lawmaker requested an audit when savings estimates changed without explanation.

In a statement to The Gazette Thursday, State Auditor Mary Mosiman said her office has “decided to proceed with a review” of Iowa’s Medicaid managed-care program.

“We realize the cost of Medicaid is an important issue to Iowans,” Mosiman wrote. “As always, we will report any findings directly to the people of Iowa. Any report we publish will be available on our website at”

Last month, Sen. Pam Jochum, D-Dubuque, sent a letter requesting the state auditor’s office seek documentation from the Department of Human Services and the managed-care organizations it oversees “to determine if Iowans are really saving money by paying out-of-state, for-profit insurance companies to care for our most vulnerable.”

Jochum sent the letter after DHS — which oversees the state Medicaid program — released a new state savings estimate that claimed the state has saved a “projected annual range” of $140.9 million. DHS did not clarify how officials calculated those numbers.

This latest estimate differed from the previous cost savings estimate released in the department’s December quarterly report, which stated Iowa was saving about $47.1 million for the current budget year, which ends in June.

The $140.9 million figure also differs from initial estimates released by then-Gov. Terry Branstad before Iowa Medicaid switched to a privatized system. Branstad said at the time that Iowa would save up to $232 million by this budget year.


“The amount of savings predicted and reported by the Iowa Department of Human Services has continually changed,” Jochum said in her letter to Mosiman.

“Iowans deserve a better answer. Iowans deserve to know if their taxpayer funds are being used in the most efficient way.”

Jochum also called for the meeting to be public, telling The Gazette this past month she hoped seeing the actual savings estimates will begin the process to fix the “colossal mistake” that is Iowa’s managed-care program.

Iowa’s managed-care system, which had been operating with two private insurance companies, recently signed up Iowa Total Care — a subsidiary of Centene — as a third MCO for the program. It is set to begin administering coverage to members July 1, 2019.

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