Iowans have no idea how much privatization is costing us
Todd Mouw died in a specialty hospital after changes to his medicaid disrupted his in-home care. His wife, Cydni Mouw, believes those changes in his coverage contributed to his death.
Michael Zamora / The Register
Iowa has a new governor and new human services director. Gov. Kim Reynolds and Department of Human Services Director Jerry Foxhoven should seize the opportunity to ditch their predecessors’ Medicaid privatization experiment that funnels billions of public dollars to three private, for-profit managed care companies.
The continuation of privatization cannot be justified. Neither can the ongoing government secrecy surrounding it. The intentional, irresponsible lack of transparency raises even more suspicions this entire ordeal is a taxpayer-fleecing fiasco.
State administrators are once again negotiating behind closed doorswith the managed care companies. This time it is over payment rates to the insurers that were supposed to go into effect July 1. Officials will not explain why talks have dragged on for weeks. They will not provide any estimates on how much more money taxpayers may have to fork over.
These administrators are paid with public dollars, doing the public’s work, negotiating details of a public program with millions of public dollars at stake.
Yet the public is prohibited from knowing anything.
Apparently the rest of us, including legislators who appropriate funds for Medicaid, are supposed to just shut up and pay up after the covert negotiations conclude. We are supposed to ignore how money is used in a $4 billion government program that provides health insurance to about 600,000 poor and disabled Iowans.
Is collecting public dollars with no public accountability what the for-profit companies want?
Amerigroup, AmeriHealth Caritas and United Healthcare entered contracts with the state last year to take over Medicaid management. These are established insurers with numerous actuaries and years of experience. They knew exactly what they were doing when they agreed to collect a set amount of money per Medicaid beneficiary and pay for care and services of the individuals.
Then, like private Medicaid insurers have done in other states, they immediately started complaining they were losing money. They asked for more. Iowa gave it to them. They asked for more again. Iowa scrambled to make sure they got it. The insurers say they are drastically underpaid and describe privatization as a financially “catastrophic experience.”
Oh, the irony.
It is Iowans who experienced catastrophes when they lost health services, including in-home care. It is the medical providers who experienced catastrophes and closed their doors because insurers didn’t pay. While taxpayers have never received any reliable evidence privatization would save the state a penny and insurers demand more and more money, it seems the state is headed for a financial catastrophe.
Since privatization is not working out for anyone, including the managed-care companies, the insurers should welcome Iowa canceling their contracts with the state. That is exactly what the Reynolds administration should do.
Iowa can return to the state-managed Medicaid program it operated successfully for decades. The government reliably paid health providers. It held down costs. And it was transparent. Taxpayers were not left in the dark about how public health dollars were being spent.