On Medicaid Privatization and What To Do About it

Throughout my life, I have known a variety of people with various challenges in their lives. Some were emotional, others economic and other more physical. Either way, we all have challenges, and nobody knows this better than the disabled community. Their tenacity and strength when dealing with the challenges they face in life is awe inspiring and should serve as a reminder of the strength of the human spirit. Even the strongest among us need help, and with the current status of Medicaid, I fear that many of these people will be needlessly harmed thanks to the privatization of Medicaid.

Healthcare has always been a continuous issue. Approximately 51 percent of Iowans in a recent poll said that Healthcare was their top issue of concern (Jacobson, Telegraph Herald). Why wouldn’t it be? These very livelihoods affect plenty of people all around us and we should do everything in our power to help them. There are approximately 680,000 poor or disabled Iowans covered under Medicaid whose livelihoods and wellness rely on the assistance these programs provide (Clayworth, Des Moines Register). These people need and deserve to have access to proper coverage in the system so that they can face the challenges they deal with on a daily basis with the full strength of their hearts and minds. Since Medicaid was privatized under former Governor Branstad, there have been a litany of problems that have burdened those of which Medicaid is supposed to cover. One of the four companies that was initially trusted to care for all these people had to pay approximately $138 million in order to settle claims of over-billing for Medicaid services. Furthermore, all four companies had 1,500 regulatory sanctions against them combined and have paid a total $10.2 million in fines for the last five years (Milbank, Washington Post). Furthermore, one of the three managed-care organizations that was initially trusted to handle care has dropped out, leaving only two of them to face the coming tide (Jacobson, Telegraph Herald). There have been 200 cases in which people have been denied proper care and have had to appeal to Iowa administrative law judges, and the judges concluded that they had been unfairly denied coverage. Of those cases, four of them were denied due process via improper notification, and were denied or delayed their in-home care. Even when they won their appeals, companies routinely reevaluated the appeals only to notify them within 60 days that they are once again being denied coverage (Clayworth et al., Des Moines Register). This endless loop of denials, appeals and genuinely predatory behavior by these companies is unacceptable and must be addressed immediately.

Of course, the justification for this anathema of a program is money. Proponents of the current state of Iowa Medicaid will inevitably argue that it saves the state money to go private. However, since the implantation of Medicaid privatization, per member cost for just the first year went up by 4.4 percent and the average rate of increase per member was 1.5 percent (Jacobson, Telegraph Herald). Proponents of Medicaid argue that the switch would save the taxpayer approximately $232 million for the 2018 fiscal year. However, that number plummeted to a paltry $47 million. This cost has turned the people against the privatization of Medicaid with 48 percent supporting the old state-managed system and only 28 percent of respondents supporting the privatization (Leys, Des Moines Register). The proponents of this system can’t guarantee that it will save money, they can’t ensure those in charge will be held accountable and they can’t ensure people will be covered properly. We need to do better and speak up while the damage can be undone.

 

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