Iowa: 425,000 Medicaid enrollees paying the price for GOP's privatization fetish

Combined, the Medicaid and CHIP programs have around 72.5 million Americans enrolled in them as of December 2018. However, the vast majority--over 80% of them--are actually enrolled in privately managed Medicaid programs. Managed Care Organizations (MCOs) are private health insurance companies which states contract with to handle the administration and management. In some cases this works out reasonably well. In others...not so much:

UnitedHealthcare is pulling out of Iowa's private Medicaid management program

More than 425,000 poor or disabled Iowans will soon have to switch health insurance carriers. 

UnitedHealthcare, which manages health care for more than two-thirds of Iowans on Medicaid, is leaving the market, Gov. Kim Reynolds’ office announced late Friday afternoon.

...UnitedHealthcare was paid about $2 billion in federal and state money to manage Iowans' health care last fiscal year. It is the second Medicaid management company to bail out of Iowa since the state’s controversial decision to privatize its Medicaid system. AmeriHealth Caritas left the state in 2017 after complaining that it had lost hundreds of millions of dollars on the project.

...Foxhoven said in an interview that the main sticking point in negotiations was UnitedHealthcare wanted to be released from contract terms that would have denied them part of their state payments if they didn't meet quality goals. 

..."It's time for Gov. Reynolds and GOP lawmakers to finally admit that Medicaid privatization is failing and it needs to be fixed immediately," Rep. Lisa Heddens, D-Ames, said in a news release.

...Sen. Zach Wahls, D-Coralville, tweeted: "This news confirms what hundreds of thousands of Iowans already know: Medicaid privatization has been a disaster from day one. It's time to end this failed experiment and put Medicaid back under state control."

Sen. Joe Bolkcom, D-Iowa City, called the situation “an absolute disaster” and said it’s time for the state to take back control of its Medicaid system. He said he was skeptical Reynolds has saved Iowa money in her negotiations with the companies managing the state’s Medicaid program, noting that the budget for the program has increased each year.

I'm old enough to remember when Obamacare was criticized for hundreds of thousands of people being forced to switch to a different healthcare plan due to insurance carriers dropping out of the ACA exchanges...

Advertisement