Letter to the Editor: "Support Kayla Koether for State Assembly"

Currently, 680,000 low-income and disabled Iowans, over 20 percent of the state's population, depend on Medicaid.  In April 2016, the governor unilaterally privatized Medicaid with disastrous results for the people of Iowa.  Privatized programs have high administrative costs, built-in profits, and rarely save money or improve care. Their route to financial success is by finding more ways to limit care and deny services. Consider the following effects of Iowa's Medicaid privatization:
•        In August 2016, only four months into the privatization effort, a survey – including over 400 Iowa doctors, hospitals, local clinics, and nonprofit health care providers – found that the majority of Medicaid providers weren't being paid on time by the Managed Care Organization (MCOs) and their administrative costs were already increasing under the privatized system. 
•        Claims denials are putting lives at risk, and in some cases, have resulted in death. One Iowan who relied on a ventilator wasn't able to live at her local nursing home because the facility made the decision to no longer accept patients on ventilators due to insufficient and untimely payments from the MCOs administering the state's Medicaid program. The woman ultimately died shortly after she was moved to a temporary facility in fall 2017.
•        Nine months after its departure, Iowa providers are still waiting for AmeriHealth (one of the original MCOs) to pay numerous claims they are owed.
•        An Iowa mom waited for five months for approval of an open heart surgery for her 5-year-old son as Amerigroup, one of Iowa's MCOs, dragged their feet.  In an act of absolute desperation, fearing her son would die without the surgery, she was forced to go straight to the Governor in order to get action from Amerigroup.
•        A 4-year old who was forced to regress to crawling for 6 months while his parents engaged in a frustrating appeals process because Amerigroup would not pay for his customizable walker.
•        A 37-year old man with Down Syndrome required 12 catheters per month to decrease the chance of infection.  United Healthcare, one of the two remaining MCOs in the state, denied payment for 11 of the 12 catheters even though using one catheter for an entire month substantially increased his chance of infection.
•        AmeriHealth Caritas, one of three MCOs originally selected by the state, pulled out in November 2017.  This MCO had enrolled the largest number of Iowa Medicaid recipients as well as the largest concentration of special-needs patients.  Their departure, after only 20 months, forced over 213,000 Iowans to move to one of the two remaining MCOs. 
•        10,000 of those individuals chose Amerigroup, but Amerigroup then announced it could not accept additional patients.  These patients were then shifted to a state-run program.  Three months later, the 10,000 plus patients were moved back to managed care under Amerigroup.
•        The remaining 200,000 patients moved to UnitedHealthcare; however, many of their physicians and other providers were not credentialed by UnitedHealthcare.
•        The state sought a third MCO to replace AmeriHealth and selected Iowa Total Care, which will move into the program in July 2019.  Serious charges of mismanagement, resulting in $23.6 million in fines across a dozen states, have already been leveled against this MCO which will be managing care for Iowa patients.