Among all the problems spawned by handing Iowa’s Medicaid program over to private managed care, the denial of services to sick and disabled Iowans tops a very long list. And the notion that these denials put corporate profits ahead of patient needs has driven much of the most intense criticism of the privatized program covering 600,000 Iowans.
That’s why it was welcome news this month when the U.S. Office of Inspector General announced it’s launching a nationwide investigation into the denial of services to Medicaid recipients by managed care companies. That investigation will include Iowa, where former Gov. Terry Branstad transferred control of Iowa’s Medicaid program over to private management in 2016. Current Gov. Kim Reynolds has continued and defended the privatization effort.
The investigation was requested by U.S. Sen. Bob Casey of Pennsylvania, who was troubled by news reports in the Des Moines Register and Dallas Morning news chronicling the denial of critical services and the failure of MCOs to inform clients of their appeal rights.
Iowa’s privatized program has been beset with reports of dropped services, bureaucratic tangles and unpaid bills to health care providers. Promised savings to taxpayers haven’t materialized. Just weeks ago, one of the MCOs, UnitedHealthcare, announced it is leaving Iowa’s program amid disputes over costs and standards. The move will force hundreds of thousands of Iowans to switch coverage providers.
Reynolds’ spokesman said the governor welcomes the Inspector General’s review. So do Democrats, who have been highly critical of transition to private management.
“At least we have the ear of someone who can make a change in all of this,” said state Sen. Liz Mathis, D-Hiawatha.
Our hope is that amid all of the accusations, controversies and political debates swirling around Medicaid in Iowa, the Inspector General can bring an independent view, a fresh perspective and hold both state officials and MCOs accountable. Iowans need clear answers to the many questions raised by the program’s poor performance. We need spin-free information that can guide efforts to clean up the mess and chart a better path forward.
The Inspector General’s report is expected in 2020. It can’t come soon enough.
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