Thumbs down for Iowa's privatized Medicaid program

Winneshiek County health care providers and relatives of Medicaid recipients say the state's switch to private managed care organizations to supervise the state's Medicaid program has created one confusion after the next.

State Senator Joe Bolkcom of Iowa City got a chance to talk with about two dozen people Friday at NICC Calmar about the April 1st switch to private MCOs.  "It's a work in progress," said one health care provider.

Others were not as complimentary.  The relative of one Decorah Medicaid recipient said her brother was "panicky and freaking out" about the change in administration of the program.  "We've put them in a horrible situation," she said, adding that the Medicaid recipients are "baffled and confused" by the new system.

Another relative of a Medicaid recipient said the rollout of privatized management "has been a complete joke."  She complained about the amount of time she has had to spend on the telephone, talking with MCO and state staffers, trying to clear up coverage issues.  "This is not how I want to spend my time—I'd rather spend it helping my daughter."

Another health care provider complained of "daily, sometimes hourly changes" in what the private Managed Care Organizations require.

Senator Bolkcom told the group he has a number of concerns.  For instance, the managed care organizations rely on taxicabs to give Medicaid patients a ride to their health care provider—but that often means calling a taxi company out of Waterloo or Cedar Rapids, even though they need only a short cab ride within their small town 30 miles away.  Bolkcom says he's also worried about the new guideline that allows up to 12 percent of funds to be paid for administrative costs.  "We want to track outcomes," Bolkcom told the group, saying the state legislature is working to pass a bill that would give it oversight of the new system.  That "is a bit of a partisan issue," he admitted, because House Republicans don't want to embarrass Governor Terry Branstad, who started the privatization.

560,000 Iowans received Medicaid benefits.  Roughly 70 percent of Iowa Medicaid's 4.2 billion dollar budget funds the care of Iowans living with disabilities and the very poor elderly.