Dubuquers still adjusting to Medicaid privatization

DUBUQUE – ¬†Governor Terry Branstad privatized Iowa’s Medicaid system last April.

It’s been five months since it’s been in the hands of three Managed Care Organizations, but families are still left with many unanswered questions.

Carole Porter has been navigating the transition with her son since it was announced. She sums up the process in just a few words.

She said, “It’s been very rocky, frustrating, unable to get answers.”

Carole’s biggest concern for her son is making sure he gets all the services he’s used to having, like his community trainer who supervises him at his volunteer jobs.
She has asked her MCO, Amerihealth Caritas, if they will be cutting services in the future. She said, “Their comment was, its not our intention to cut services, well try to keep them the same as much as possible. So that leaves it wide open.”

On top of worrying when Bryan’s services will be cut, Carole says she dreads each doctor’s appointment, because she never knows if their MCO will authorize it or not.

“It doesn’t matter if its a routine type of thing, because if the Managed Care Organization you’re with feels its not necessary, they won’t authorize it, so it won’t be covered.”

Democratic Iowa State Senator Pam Jochum is helping Iowans navigate this new privatized model.

She held a listening meeting Thursday, September 22 where caretakers and providers expressed their concerns.

Most were concerned with appointments, medications and therapy appointments needing to be preauthorized, just like Carole.

Amerigroup represenative John Hedgecoth explained to the group why his company requires preauthorization.

He said, “Because you could go along providing services for a year, a period of years, and then find out that a big chunk of services were not medically necessary.”

For Jochum, John’s answer confirmed what she already knew.

“If the private insurance companies could have done this, they would have done it long ago. But they could not find a way to provide that insurance and turn a profit.”

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Allison is a senior at Loras College and is a Dubuque native. She's the Producer of LCTV News, along with Payton Van Vors, as well as an anchor and reporter. This past summer, Allison had an internship with KCRG in Dubuque, and she's continuing to work for them this Fall. Allison reports because she loves keeping her community informed on issues and events that matter to them.

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