Lawmakers come under fire over Medicaid woes

Problems within the state’s decision to privatize Medicaid have lawmakers coming under fire as they head back into session this week, but while Iowa Gov. Kim Reynolds agreed the rollout hasn’t been perfect, she said the state is committed to improving those issues and moving forward with the privatized system. At a forum sponsored by the Associated Press last week, Reynolds offered some solutions.

“We have made mistakes. The rollout was not perfect, but it is the right thing to do,” Reynolds said. “But we have to recognize admit the mistakes we made, and we have to look at ways to move forward.”

Iowa’s Medicaid program, which was privatized in 2016, has been under added scrutiny since November when one of the three insurance companies overseeing the system dropped coverage. The managed care organization (MCO) AmeriHealth failed negotiations with the state over money. Since then, the Iowa Department of Human Services announced there would be limited choice temporarily for patients between the remaining two companies.

The $5 billion program, which is funded through a combination of federal and state funds, serves more than 600,000 people.

Sandy Ham is CEO of Progress Industries in Newton — a nonprofit organization which provides services to people with developmental disabilities. In a community leadership forum hosted Jan. 4 by Newton CSD, she said her organization, which receives 90 percent of its funding from Medicaid, was recently informed by the state they would be losing funding.

Ham said Progress Industries would likely have to cut its budget by 12 percent by 2019 while maintaining the same level of services.

“I don’t know any business that’s been handed a 12 percent revenue reduction and managed to survive,” Ham said. “We’re fighting for our survival right now ... I’m trying to understand when there will be some accountability with what we’ve done with Medicaid and what we’re going to do going forward to help good organizations such as ours to not have to go out of business.”

“It’s been a bad rollout and devastating to most of our providers who provide services in the Medicaid system,” Rep. Wes Breckenridge, D-Newton, said. “We need to make sure there’s oversight to those MCOs, we fix the system that’s in place or we go back to the state-run system.”

Sen. Chaz Allen, D-Newton, stated publicly he feels legislators need to create an oversight panel to monitor the situation. He’s not satisfied with the state’s efforts to fix the problem so far.

“They need oversight; it’s like the fox guarding the hen house,” Allen said. “Our communities can’t provide the services that they need alone. I want to see a legislature oversight panel that will look at this.”

Despite the issues facing the state’s Medicaid system Sen. Amy Sinclair, R-Allerton, said going back to the old system isn’t an option for the state, rather, the focus needs to be on fixing the current system. Sinclair said she’s been in contact with Reynold’s office, and the governor has assured her that fixing Medicaid will remain a top priority in 2018.

Some of Reynold’s proposed fixes for the troubled system include hiring Michael Randol to take over the state’s Medicaid program. Randol, who previously ran Kansas’ Medicaid program, will work with the governor’s recently appointed director of the Iowa Department of Human Services Jerry Foxhoven to make sure Iowans are getting the care they need Reynolds said.

Legislators said they’ve heard plenty of complaints about the state’s Medicaid system, both from constituents as well as other members of the legislature, but they’re ensure if there’s a legislative fix that would improve the system. Still, Iowa House Speaker Linda Upmeyer, R-Clear Lake, warned reporters last week if the state is unable to clean up the Medicaid mess the legislature will feel compelled to step in.

When the Medicaid rollout began, Upmeyer said she knew there’d be issues, but she said she hasn’t seen the kind of improvement she’d been expecting. Fixing the state’s issues with the Medicaid system may require a bipartisan solution, Upmeyer said.

“We’re all interested in making sure the system [Medicaid] works more effectively,” Upmeyer said.

NDN Reporter Mike Mendenhall contributed to the report.

Contact David Dolmage at 641-792-3121 ext. 6532 or ddolmage@newtondailynews.com