A bill supporters say makes it harder for managed care companies to prioritize profits over the healthcare of Medicaid recipients passed the Iowa Senate Wednesday. Every Senate Democrat and six Republicans voted for the legislation.
Medicaid enters privatized management next month, and critics of the transition are eager to install safeguards. The bill, penned by the Senate's Human Resources Committee, includes provisions for consumer protections, making sure networks have enough providers, methods to determine reimbursement rates, and outcome expectations.
"The Medicaid privatization program is destined to harm the very people it was supposed to help," says Sen. Amanda Ragan, a Democrat from Mason City and head of the Human Resources Committee. "Apparently it was designed by those who know the cost of everything and understand the value of nothing."
Sen. Brad Zaun of Urbandale is one of the Republicans who broke with his party in support of the bill. He says people on both sides the aisle failed Iowans last year by focusing on managed care’s projected savings, without fully considering how privatization could affect the quality of Medicaid.
"I’m just disgusted. I'm disgusted we’re having this conversation. What we’re trying to do is make the best out of bad situation," says Zaun.
Gov. Terry Branstad says privatization is necessary because otherwise Medicaid would consume too much of the state's budget.
Many Republicans are resistant to oversight, in part because it chips away at the projected savings created through privatization. Another concern is that more oversight cuts back on a health management company's profits.
"Do we want these managed care companies to be successful?" asks Sen. Mark Chelgren of Ottumwa. "I want these managed care companies to be successful because the people of Iowa deserve it."
The bill will now go to committee in the Republican controlled Iowa House.