Branstad remains clueless about Medicaid woes
Editorial: Branstad remains clueless about Medicaid woes
The Register's editorial5:55 a.m. CDT August 24, 2016
Last year, Gov. Terry Branstad’s spokesman told The Des Moines Register the governor believed Obamacare “is unaffordable, unsustainable and creates too much uncertainty for Iowans. The implementation of this law has been flawed from the very beginning.”
Oh, the irony. Iowans currently are mired in the disaster of the Medicaid privatization plan Branstad foisted upon the state this spring.
Less than five months after its implementation, numerous providers report not having been paid for health services. Some are borrowing money or closing up shop. Low-income Iowans insured by Medicaid say they cannot obtain prescription drugs. Two of the three for-profit companies contracted by the state to administer Medicaid — the only entities that stand to benefit from privatization — are even reporting huge financial losses
In documents provided to the state, AmeriHealth Caritas reported it ran a $42.6 million deficit in the first six months of 2016, and Amerigroup reported it lost $66.7 million.
It is hard to make sense of that. How can the companies be losing money when so many providers are not being paid? Did these established, experienced companies miscalculate the cost of such a huge undertaking before signing contracts with the state?
Of course, the public can’t know, as the managed care organizations refuse to discuss the specifics of their financial reports with the media. “It is not appropriate to discuss” the company’s financial report in detail, an AmeriHealth spokesperson told a Register reporter this week. Welcome to privatized Medicaid, where it is apparently inappropriate for companies collecting millions of public dollars to administer a public program to give information to the public.
What we do know: The managed care companies appear to be following the same game plan embraced by their counterparts in Florida. After statewide privatization of Medicaid there in 2014, the companies quickly claimed they were losing money.
So what could happen next in Iowa? The providers can ask the state for more money, deny care to Iowans or break their contracts with the state.
Let's go with that third option. Break the contracts. End this madness. Return to Medicaid administered by the state, which has worked well for decades. Salvage the state’s health care infrastructure before it’s too late.
Unfortunately, Iowa’s governor appears to be absolutely clueless about this system's widespread problems. On Monday, he unveiled a new theory for why Iowa providers are not being paid: We’re rooting out fraud and abuse.
“The reports that we have been getting have been that this new system of managed care replacing the unmanaged care that we had before is stopping significant fraud and abuse,” he said.
Hmm. Could the governor please produce these reports? Do they exist? Because he was unable to provide a figure on the amount of fraud and abuse. He didn’t cite a single example of a provider that was previously gaming the system.
Then again, providing evidence to support his privatization brainchild has never been the governor's strong suit. He couldn’t provide evidence when he claimed privatization saves money. He couldn’t provide evidence when he said privatization improves health. Now he can’t provide evidence that fraudsters are being stopped in their tracks.
Apparently, Iowans are just supposed to pray the governor's privatization mess will work itself out. So far, those prayers are going unanswered.
State workers reduced fraud and abuse
In Fiscal Year 2015, the state was administering Medicaid. According to the state's own report, that year alone it collected $272 million through cost avoidance and recovery efforts and saved nearly $47 million identifying overpayments, coding errors, fraud and abuse. Coordinating home-based care contributed to a 19 percent reduction in emergency room visits and a 17 percent reduction in inpatient admissions to hospitals. And it paid health care providers.