- Dave Heaton is a former state representative from Henry County who chaired the Health and Human Services Appropriations Subcommittee.
To readers: The video above is from 2019.
A little more than six years ago, the state of Iowa initiated a new approach to the administration of our Medicaid program. At the time, Gov. Terry Branstad put the state on a path to a managed care system that sought to improve the long-term health outcomes of Iowans while providing a more sustainable financial framework for the state in the years to come.
After assuming the governor’s office in 2017, Kim Reynolds embraced this approach as well, and today more than 775,000 Iowans, or about 1 of every 4 residents of the state, are in the Medicaid managed care system. Most of the people reading this, whether they realize it or not, will have neighbors, friends, or extended family members who are Medicaid recipients.
More:Medicaid Managed care is a model that works for Iowa and Iowans
From my perspective, managed care works for Iowa on a variety of fronts. This program, IA Health Link, provides a more individualized approach that prioritizes identifying and addressing health issues early before they become more serious or chronic conditions. For patients, the benefits are clear. It’s better to take medication in your 30s to address high blood pressure than absorb the significant costs associated with a major cardiac event in your 50s. Additionally, managed care helps bring far more certainty to our state budget year in and year out. Without this type of approach, the health care costs assumed by the state would have grown to the point where painful cuts to other areas of the budget, such as K-12 education and public safety, would have been necessary. For these reasons, I believe the state leaders and policymakers who initiated the transition to managed care and then implemented the program over the past six years deserve real credit.
But no program is ever perfect. The initial shift to Medicaid was bumpy, as it required new processes to be established, new managed care organizations to enter the state, and a different way of going about health care that was not most people’s experience up to that point. What I have appreciated is that state leaders did not stubbornly refuse to make changes. Instead, they have evaluated the program by collecting a wide range of data from members, providers, and more to determine what is working and what is not working.
The governor and the Legislature concluded the previous year with a $1.2 billion surplus. That is a real achievement and demonstrates an ongoing commitment to fiscal responsibility. But it also underscores that we have the resources right now to meet the challenges faced today by Iowa’s Medicaid program. Consider this: Today, 400,000 Iowans ages 0 to 21 receive their health care through Medicaid. Newborns, toddlers, elementary school kids, and more rely on this program to create a strong and healthy foundation for their future. Reaching this goal requires an investment and following through on our existing commitment to cover health care services that have been promised.
Another View:Opinion: 5-year anniversary of privatized Medicaid is bad news for Iowa taxpayers
Today, policymakers at both the state and federal levels need to take a hard look at how Medicaid is funded and managed. They need to ensure that Medicaid has the resources necessary to maintain and support the health care services that managed care organizations are required to provide.
My sense is that our health care system is in a very precarious position at this moment, and preserving it requires action now.
Health care providers are facing the same cost increases that have driven up prices in every sector of the economy. A tight labor market means facilities of all sizes are struggling to attract new team members and retain critical staff. At the same time, Medicaid pays the lowest rates for health care services, as compared with private insurance or other payment options. This will impact providers even more in the years to come, as the number of Iowans on Medicaid is only projected to increase. The one-two punch of rising costs and low payment rates threatens the ability of some health care providers, especially in rural areas, to deliver needed services.
Ultimately, health care access for all Iowans must be preserved. Making reasonable investments in our Medicaid system will prevent cuts in critical services and allow the program to continue working for the state of Iowa, managed care organizations, providers, and patients.
Dave Heaton is a former state representative from Henry County who chaired the Health and Human Services Appropriations Subcommittee.