Medicaid provides free or low-cost health coverage to just over a half million Iowans. They are some of the most vulnerable people in our state, including families and children, pregnant women, seniors and people living with disabilities. More than 71 percent of Medicaid dollars are spent on services for the disabled and seniors.
Iowa’s Governor once again decided—on his own—to make big changes at break-neck speed to the health care of other people. And once again, those affected don’t have much political power. The Branstad Administration is ignoring painful lessons learned by other states that have adopted the managed care approach.
The responsible way to address the issue would be to bring together stakeholders and take a systematic approach. Iowa Medicaid is, after all, Iowa’s second largest insurance company.
Right now, only two things are certain:
1. There will be major changes to the health care of at-risk Iowans and to essential services for seniors and the disabled. This includes the social safety net that families depend on in times of need. All of us are just one terrible accident away from needing care for the rest of our lives.
2. With a cost of $4.2 billion, this will be the largest single purchase in state history. The winners most likely will be for-profit, out-of-state companies that will take home as much as $630 million a year.
Under existing state law, the Governor has a great deal of freedom to make this transition with little or no legislative direction. That’s why the Iowa Senate unanimously approved SF 452. The bill:
• Creates a process to closely monitor the transition, ensure that tax dollars are used wisely, and give vulnerable Iowans access to critical healthcare services.
• Outlines consumer protections to ensure continued access to high-quality care, emphasizing consumer choice, self-direction, nearby access and more.
• Ensures fair reimbursement for healthcare providers, the Iowa-based organizations that will actually do the work, while taking part in coordinated care to improve health outcomes.
• Establishes a legislative oversight commission to monitor implementation and recommend corrections should problems ari