Social service providers and concerned citizens from southwest Iowa gathered Friday at the Union County Democrats headquarters, 216 W. Montgomery St., to discuss Medicaid privatization, which has been described as a “self-inflicted disaster brought on by the governor,” by Troy Price, chairman of the Iowa Democratic Party.
When Governor Terry Branstad moved the Medicaid system to a privatized model in 2016, it became a for-profit model. Some opponents claim it allowed state officials to wipe their hands of any blame in a broken Medicaid system and for out-of-state corporations to set the policies making it more difficult to access quality care while simultaneously lining their pockets.
Derek Laney, the CEO of Iowa Focus, and a self-proclaimed Republican, joined the roundtable discussion with Democrats to express his mutual concern.
“It was about saying, ‘We as the administration can not openly say we want to cut funding for medically needy and fragile.’ The public loves to hear that [the administration] are all for efficiency and getting rid of fraud and waste. Private companies are better at that. Americans like to believe that. I believe that,” said Laney. “But, what they really meant was, ‘We’re going to let them (private companies) carry this ball, because as politicians we get to say we just voted for efficiency. They are the bad guys.’”
Price denounced Gov. Kim Reynolds for not taking the lead on reversing actions done by Branstad’s administration.
“She’s had opportunities throughout the course of her administration to change course,” said Price. “Unfortunately, she has not. She has chosen to double-down on a system that we know and is clear to everyone is broken.”
Price said more than 40,000 Iowans have had services cut and that the cuts have severely affected the most vulnerable.
Carol Cason of Mount Ayr, through tears, talked about how her adult daughter, Cathy, was no longer able to work in the community because of budget cuts as a result of Medicaid privatization.
“Let them live on $886 a month and not being able to work in a sheltered workshop. Not being able to make minimum wage. That’s what my daughter has,” said Cason.
Cason said her daughter is able to work and live with a person assisting her. However, budget cuts to programs and services once funded by Medicaid have made these possibilities less viable.
“She’s very high functioning. We were told she would probably never walk, talk or feed herself or do anything but she proved us all wrong,” said Cason. “She normally goes 90 miles a minute, so she’s not ready for a nursing home and I refuse to put her in one.”
As services and coverage dwindle for Cason’s daughter and people like her, patients and the providers alike are drawing attention to issues with the appeals process.
“In a former system, we would have been able to appeal to a case manager independent of the funding stream. A case manager who does not work for the same company who makes money off of not serving your daughter,” Laney said to Cason.
Price shared the story of a Tama woman, a former social worker, who now works part-time and stays home to take care of her 29-year-old son, whose brain development stopped after one year. He had profound disabilities and while his mother continued to work part-time, she stayed home to take care of him and she was paid to do so through Medicaid.
After Medicaid was switched to the privatized model, it took her seven attempts to sign her son up for services.
“The first couple of times, they claimed they never received it. Then she sent it by registered letter. They said they never got that even though she had the signed receipts. She faxed it. She got the confirmations that it went through. Seven times she attempted to get him signed up. And, then that company went out of business. She had to start the process over again,” said Price.
Opponents of Medicaid are expressing their disdain because they feel the privatized system is hurting its most vulnerable people.
“The whole thing is predicated on the idea that we would be saving all this money,” said Price. “We can see that it really hasn’t saved all that much money. They can’t even tell us how much money it has saved us or how much money it is truly costing.”
Last month, Iowa agreed to give United Healthcare and Amerigroup 7.5 percent more state money to manage its $5 billion Medicaid program, starting this fiscal year, which began July 1. This agreement means state leaders must come up with approximately $103 million more than last fiscal year.
“This means cuts to other services and cuts to other areas,” said Price. “This is the state of play we are in. This is where we are at. We are out here talking about this because it impacts so many people – 600,000 Iowans utilize Medicaid. We know we have to change the system.”