“Believe me, there are a lot of eyes making sure this is going to work,” state Sen. Tim Kraayenbrink, R-Fort Dodge, said Wednesday evening during an Eggs and Issues forum.

State Rep. Rob Bacon, R-Slater, said there’s “a lot of oversight on this.” But he acknowledged that there are questions still lingering about the switch.

“Where’s this going to go?” he asked. “We’re not sure. This is a work in progress.”

Bacon; Kraayenbrink; state Sen. Jerry Behn, R-Boone; and state Rep. Mike Sexton, R-Rockwell City; fielded several questions on the new Medicaid setup during a rare evening edition of the Eggs and Issues forum typically held on Saturday mornings while the Legislature is in session. The Legislature adjourned last month.

State Rep. Helen Miller, D-Fort Dodge, did not attend because she was traveling, according to Jim Kersten, who was the forum’s moderator.

About 20 people attended the forum at Iowa Central Community College. Eggs and Issues is sponsored by the college and the Greater Fort Dodge Growth Alliance.

Medicaid is a federal and state health insurance program for the poor. Bacon said it is a “driving force of the budget.”

In a bid to save millions of dollars annually, Gov. Terry Branstad implemented a plan in which three managed care organizations run the Medicaid program. Those companies are Amerigroup Iowa Inc., AmeriHealth Caritas Iowa Inc. and UnitedHealthcare Plan of the River Valley Inc. The transfer of Medicaid administration from the state to those companies was effective on April 1.

According to Bacon, many of the perceived problems with the privatized system were easily fixed.

“Everything that was a huge problem at first turned out to be a minor problem with just some communication,” he said.

However, Kraayenbrink said he had to call one of the companies and insist that it pay some local health care providers. He said he demanded that the company not only make the payments, but send the checks by overnight mail.

When asked who would decide if the managed care system is a success, Kraayenbrink said the health of people who rely on Medicaid must be the determining factor.

“If we’re only in it to save money, the quality of care is going to suffer,” he said.

Tax and budget issues

Behn said lawmakers spent weeks during the past legislative session on a tax issue that’s usually wrapped up quickly. That issue is linking Iowa’s tax rules with those of the federal government. Usually, he said, that’s done quickly and in a bipartisan manner.

Failing to link the state and federal tax codes amounts to a tax increase for small businesses, according to Behn.

But this year Branstad didn’t want to completely link the two tax codes and the Democrats who control the state Senate sided with him.

“The Senate Democrats hid behind the Republican governor,” Sexton said. “Once they did that, everything went helter-skelter.”

After several weeks, a deal was finally struck to link the two tax codes.

“I’m very frustrated with my governor,” Sexton said.

Looking forward to the next fiscal year, which will begin July 1, 2017, Kraayenbrink said that the state now has less than $80 million in the ending fund balance that is the government’s savings account.

“If you think this year was challenging, next year is really going to be challenging as far as finances are concerned,” he said.

Behn offered a similiar warning.

“Next year when we roll into town it’s going to take some serious work to get the budget to balance,” he said.

Local lawmakers vow to keep an eye on Medicaid managers
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