Brown, Prichard discuss Medicaid in Rockford

By James Grob, jgrob@charlescitypress.com

What they lacked in numbers, they more than made up for in substance.
Only about a half-dozen people joined Iowa Sen. Waylon Brown, R-St. Ansgar, and Rep. Todd Prichard, D-Charles City, at a legislative town hall meeting in Rockford on Saturday at the Rockford Community Room in Rockford City Hall.
Those who did attend, however, brought plenty of material for the legislators to talk about.
John Pearson if the Floyd County Farm Bureau facilitated the town hall meeting. The legislative events are sponsored by Floyd County Farm Bureau, the Butler County REC and the Charles City Chamber of Commerce.
One of the hottest topics on the minds of those gathered was the state of health care in Iowa — in particular, the privatization of Medicaid, which was in the news once again last week, when one of the three insurance companies providing services for the Iowa Medicaid program announced it was leaving the program.
“I want to know what’s happening to get rid of that privatization of Medicaid,” said one woman in attendance. “I’ve seen it in my own house, and I’ve also seen in on the other end as a provider. You authorize procedures on a patient and then have your billing person come back two months later and tell you it wasn’t approved, you have to eat all that money.”
“I hate it,” said Prichard, who has been adamantly critical of the system since the changes. “If Iowa’s Medicaid system was a car, we’d have taken it to the junkyard years ago. This is not working.”
UnitedHealthcare recently informed the state it would leave in the next several months.
“This is a situation that we need to work through,” Brown said. “Right now, with United leaving, I want you to understand that they came to the table and said they wanted $30 million more.”
Brown said the MCO also demanded state guarantees that simply were not acceptable, and requested no more state oversight.
“I do not agree with the MCO option and I do believe that we need to find a way to deliver the services to the individuals that need the services,” Brown said.
Former Gov. Terry Branstad hired private companies to manage the Medicaid program previously run by the state in 2016 and it has been the target of criticism since for cuts in services, reported slow payment of bills and doubts about its promised savings to taxpayers.
“I hear from providers all the time who say they can’t afford to take Medicaid anymore,” Prichard said. “It’s a disaster for 425,000 people.”
DHS Director Jerry Foxhoven said the 400,000 Medicaid recipients with UnitedHeathcare will be asked to choose one of the other two companies, Amerigroup of Iowa or Centene Corp. subsidiary Iowa Total Care for coverage.
Gov. Kim Reynolds says she ended negotiations with UnitedHealthcare when the company dictated contract terms she believed unreasonable.
“You got yourself into that predicament,” said another one of those gathered. “When it was administered through the state, it was much cheaper.”
Foxhoven says the company wanted full payment without meeting all required performance requirements in its contract.
UnitedHealthcare says persistent funding and program design challenges made it impossible for them to provide the quality care and service they believe people deserve.
“I am not in favor of the MCO model,” Brown said. “I introduced a bill that moves us toward an ASO model — that’s Administrative Services Organization.”
Brown said that the ASO model is based on a merit-based system.
“It’s based on how they get paid, but it brings the providers and everyone to the table to make sure that the patient gets what they need,” he said. “It also makes sure the payments will be going to the providers.”
Prichard and Brown went through a list of other public policy proposals that have been considered in the Iowa legislature this year, and listed off bills that were still alive and bills that had died and committee this year.
Among bills still alive are a reorganization of the children’s mental health system, expanded access to birth control. changes in the judicial nomination process, increase of penalties for animal cruelty, changes to medical cannabis laws and sports betting.
Bills that are dead include banning traffic cameras, felon voting, abortion funding, mandatory E-verify, Medicaid work requirements, the death penalty and school choice, Brown and Prichard said.