Editorial: Don’t rush Iowa’s Medicaid privatization


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The Iowa Medicaid program assists in providing or provides health care to 560,000 Iowans. Prior to recent events, the Medicaid system in Iowa has been among the most efficient in the United States, with effective state and hospital partnerships for ground-level success. But a series of misguided, undercooked, and suspicious events have left a half million Iowans worried about their health care.
Medicaid privatization transfers the responsibility and management of people using Medicaid to private insurance corporations. Gov. Terry Branstad has tirelessly pushed the privatization of the state’s Medicaid system. A bidding process determined that Aetna, WellCare, and others would handle the program, but from the very beginning, the process has been nothing but turbulent. Recently, WellCare’s contract with the state was terminated under the justification of unfair bidding practices. WellCare had hired former Iowa legislators to, among other things, win the bidding. This finding is consistent with other baffling decisions that emerged from the bidding process.
The companies selected have been awarded hundreds of millions of dollars in lucrative contracts. A lot was riding on this bidding. That many of these companies have paid millions in fines, sanctions, and lawsuits related to fraud and mismanagement seems to have gone unnoticed. Other potential candidates with cleaner (and more respectable) records were passed over. Iowan taxpayers are footing the bill for these companies to be integrated into the health-care system. Here’s to hoping it isn’t all squandered on legal fees.

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Further confounding was Branstad’s persistence to fully transfer Medicaid management to the new companies by Jan. 1. This gave the state a year to transfer the $4.2 billion system, a feat never accomplished in any state. Even partial privatization has taken far longer. Branstad’s insistence may in part be motivated by the implementation strategic importance in his annual budget. The Branstad administration has adamantly declared that $51 million will be saved from the transition. Where this number came from is still a mystery.
Integration hasn’t been achieved. In the wake of the WellCare contract termination, the future of privatization is rocky. There is still a date by which the private corporations will hold Iowa’s Medicaid, March 1. Many are skeptical this new date will be achievable, including Iowa Senate President Pam Jochum.
Branstad has scoured the Earth for reasonable scapegoats, citing the federal regulators overseeing the transition. Their standards were always well-defined, though, poking holes in that defense. Seeing as Branstad may have been involved with the WellCare scandal, federal regulators might start looking like the boogeymen in his dreams.
The *Daily Iowan* Editorial Board believes Branstad’s stubborn refusal to postpone or carefully transition to private Medicaid is irresponsible. Should the rollout occur March 1 without a proper and thorough process of integration, hundreds of thousands of poor and disabled Iowans will not have access to health care. Some argue that private Medicaid will save money, some point to states in which private Medicaid has increased costs. Whatever you want to point to, the reality is that, if the transition is not managed properly, Iowa’s most vulnerable citizens will be unable to receive medical care, and that’s unacceptable.

 

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