Iowa Democrats Urging Obama to Stop Medicaid Managed Care

If you thought the high-stakes politics in Iowa ended with last week’s caucuses, think again.

The yearlong battle over whether the state’s 560,000 Medicaid beneficiaries will all moved into managed care continues unabated, and the Democrats who have long opposed the move aren’t letting up.

On Monday, two state Senate committees voted on a bill to block Republican Governor Terry Branstad from moving forward with his plan, which he said would save Iowa $51 million in its first 6 months when first proposed. But that was before delays from CMS and lawsuits from spurned contractors. While the bill has symbolic importance, it is not expected to move forward in the Republican-controlled Iowa House.

Branstad’s plan scheduled to proceed January 1, 2016, but CMS found the state was not ready to proceed and delayed the changeover until at least March 1, 2016. In the interim, the Des Moines Register produced documents that show saving estimates were later revised downward to $36.6 million.

Now the stakes are getting even higher. During Monday’s voting, a Republican senator joined Democrats in calling for a delay. Branstad’s predecessor, Democratic former Governor Chet Culver is holding his own town meetings on what opponents are calling Medicaid “privatization.” And the state’s lone Democratic Congressman is making the case to no less than President Obama himself.

US Representative Dave Loebsack released a letter dated Monday, which reads in part, “I have spoken personally to many Iowans who would be impacted by this change, including the parents of children with disabilities. Each these parents are scared that their children will not be able to access the life-sustaining therapies the need once the transition is made. …”

“These parents are not getting the answers they need,” the letter states.

At each step, Branstad has responded to critics by saying that Medicaid spending at current levels was not sustainable, and that a change to managed care was needed to deliver better coordinated care into the future. He especially took issue with Culver’s emergence in the debate, saying that the Democrat spent $440 million in one-time revenues on Medicaid, which Branstad said “dug a big hole” that had to be fixed.

Branstad told the Register, “For (Culver) to now join with the Senate Democrats to try to torpedo a thoughtful, systematic approach to modernize Medicaid to improve the health of Iowans and to better coordinate care, something that has already been done in big states controlled by Democrats like New York and California, I think is outrageous.”