BY CHUCK VANDENBERG
FORT MADISON – State Sen. Rich Taylor said this summer is not going to be good for hundreds of thousands on Iowa’s privatized Medicaid system.
At Friday’s Legislative Luncheon in Fort Madison, sponsored by the Fort Madison Chamber of Commerce, Taylor and State Rep. Jeff Kurtz both anguished over the current state of Iowa’s privatized Medicaid system.
“I don’t look for this to be a very sweet summer by any means,” Taylor said. “I think we’re going to go through the same issues we went through getting set up originally, but with only about half the people. I think we need to eliminate these MCOs that are taking care of our most vulnerable citizens.”
In the past four weeks, UnitedHealthcare of the River Valley, announced it was pulling out of the state’s privatized system effective June 30. On the heels of that announcement, the federal government’s Office of the Inspector General announced it was launching an investigation into privatized state medicaid programs around the country.
Taylor said Iowans that were covered by UnitedHealthcare are finding themselves in lost in the shuffle.
“It’s gonna be terrible. We’ve got 450,000 patients that are going to be reshuffled into the deck as to who their actual MCO is, and then does that MCO have a contract with the doctor or hospital they go to,” Taylor said.
According to Kurtz, UnitedHealthcare’s departure will effect a large number of Lee County residents.
“We’re gonna have more than 6,000 people right here in Lee County that are going to have to find a new provider.”
Kurtz was asked if it was possible to revert back to the state program and the first-term legislator said it can, and should, be done.
“We can transition back, but it looks like it will have to be done piecemeal. One of the problems is that when the state ran it, administrative costs were 3 to 5% and now they’re 12-15% and you know, 3 is less than 12, I don’t care what kind of math you take,” Kurtz said.
“This shouldn’t be a laboratory for trying to prove your economic theory. This should be something that is done to make people better, I don’t know how else to put it.”
Taylor said there are too many people losing the quality of care the state should be providing and the federal investigation could result in mandates to the state based on federal money being used in the system.
“They could have the authority to tell Governor Reynolds that if she’s spending federal Medicaid dollars, she has to get this system under control,” Taylor said.
But he said the lack of reimbursement under the current system is another problem and will add to the problem of finding an MCO that is in-network for those people.
“Why would a provider sign another contract to not get paid? Why would you do that?” he said after the luncheon. “When they don’t sign, then the little girl down the highway from me a few miles isn’t going to have any services.”
Kurtz said the investigation could take several years, but a statement on the Inspector General’s website said a report could be issued next year.
“I think we’ll know something fairly quickly, but we won’t know the whole scope of what’s going on for maybe a year or two,” he said.
“You’ve got more than 600,000 Iowans involved and it’s going to take a lot of digging. But State Auditor (Rob) Sand is involved in there and I know he’s been working on this since he took office. This was one of his big campaign promises.”
UnitedHealthcare of the River Valley informed customers it will cease operations in the Iowa medicaid program on June 30, leaving just Amerigroup and Total Iowa Care left in the program.
Patients can continue to use UnitedHeathcare until June 30, but after receiving notification, they will have 90 days to determine where they will go for health insurance.