John Pemble / Iowa Public Radio

Even though lawmakers in the Iowa Senate voted to stop privatization of the state's Medicaid program last week, the measure is unlikely to pass in the Iowa House. The system is still slated to switch to private management on March 1 unless the federal government steps in. 

Iowa Public Radio / Joyce Russell

Three State Senate Republicans crossed party lines in voting to pass a bill that would stop the privatization of Iowa's Medicaid system. 

State Sen. David Johnson of Osceola County is the ranking Republican on the Human Services Committee. He says Iowa is trying to do too much too fast and, as a result, healthcare providers and vulnerable people are getting dumped on.

“We need to put a dagger in this,” says Johnson. “It’s moving too fast, and we can come up with a better plan. I’m absolutely convinced of that."

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Former Democratic Gov. Chet Culver is now in the struggle surrounding the current Governor, Republican Terry Branstad’s plan for converting Iowa’s Medicaid program to private management. Culver is conducting several public forums this month.  In Coralville Tuesday, he listened for two hours to the fears of parents and others receiving Medicaid services about the move away from state management of the program.  He told the roughly 30 people attending the forum that privatizing Medicaid isn’t a partisan political issue.

Save Medicaid Action

Democrats in the Iowa Senate today ratcheted up their challenge to Governor Branstad’s plan to privatize Medicaid, the state’s health care program for the low-income and disabled.  

They introduced a bill to repeal the initiative, but Republicans are standing by the Governor’s proposal.  

Democrats say privatizing Medicaid will disrupt long-standing relations between patients and providers and compromise patient care.   Their bill would cancel the contracts with three for-profit, out of state companies chosen to manage the program.     

Healthcare companies WellCare and Meridian are continuing their fights to manage a piece of Iowa’s $4.2 billion Medicaid system.

WellCare was one of four companies selected to privatize Medicaid. But its contract was terminated after Administrative Law Judge Christie Scase determined it had violated rules of the bid process. 


As Iowa gears up for transitioning its Medicaid system into private management by three for-profit companies, lawmakers are grappling with how many ombudsmen are needed to give recipients assistance and objective information.

Flickr / Jennifer Morrow

With six weeks to go before Iowa’s Medicaid program is tentatively scheduled to become privately managed, Medicaid Director Mikki Stier says she's "very confident" Iowa will be ready. The federal government delayed the state's plans to privatize Medicaid on New Year's Day, despite Gov. Terry Branstad and Iowa's Department of Human Services insisting the state was ready to make the switch.  


About 20 lawyers representing six healthcare companies and the state of Iowa crowded into a small Polk County courtroom Thursday.

All want Judge Robert Blink to issue or reject various stays, or orders, relating to the upcoming privatization of Iowa's $4.2 billion Medicaid system. All also argued a ruling in their favor prioritizes the healthcare of Iowa's 560,000 Medicaid recipients. 

John Pemble/IPR file photo

Gov. Terry Branstad says the budget he’ll present tomorrow along with the annual Condition of the State Address is “very tight," but he adds lawmakers shouldn’t be caught off-guard by want he’s proposing this legislative session. 

"There's no surprise," says Branstad. "I think I've done a pretty good job of visiting with legislators about the tough decisions we have to make." 

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Iowa's Senate Majority Leader says there will be legislation that provides oversight of the transition of Iowa’s Medicaid program into management by private companies. 

"The rollout of this managed care has been messy and we're going to standup for the patients and for providers out there that need to understand the rules of the game," says Democrat Mike Gronstal of Council Bluffs, who has been a vocal critic of Medicaid privatization. "We don't think there are enough protections right now in that process, so we're going to keep working on that."

Kids on Hawk-I, Iowa’s Medicaid program for low income children, are receiving new insurance cards in the mail. But they might not put them to much use, since Iowa’s Medicaid program is scheduled to go into privatized management on March 1.

Initially the transition to privatization was scheduled for New Year’s Day. In anticipation of this date, insurer Wellmark scaled back its Hawk-I resources; but now the transition is scheduled for March so Wellmark’s Hawk-I contracts need a new home.

Joyce Russell/IPR file photo

Certainly, Iowa’s role in the 2016 presidential race has been one of the top news stories in our state this year. There are also many others - including the privatization of the state's Medicaid program. 

"This is coming from a guy who covers politics and is looking forward to the caucuses, but I would argue that this is the most important Iowa-specific story this year," explains Clay Masters, Iowa Public Radio Morning Edition host and political reporter. 

Iowa Public Radio

This week, federal administrators ordered Iowa to wait at least 60 days before shifting its Medicaid program to private management. On this News Buzz edition of River to River, Ben Kieffer asks Brian Kaskie, associate professor of health management and policy at the University of Iowa, four questions about the order.

Was this expected?

John Pemble/IPR file photo

Federal officials have told Iowa the state is not ready to transition management of its Medicaid system to private companies.  The Centers for Medicare and Medicaid Services has told Iowa in a letter today it may transition to private management on March 1st instead of January 1st, 2016, as long as the state makes sufficient progress toward readiness by that time.  

The agency says, “a transition on January 1st would risk serious disruption in the care for Iowa Medicaid beneficiaries.”

Flickr / William Patrick Butler

The Centers for Medicare and Medicaid Services is in Iowa this week accessing the state’s readiness to transition the management of Iowa’s Medicaid program into the hands of four private companies on Jan. 1. Critics say the process has been unorganized and rushed, and many Medicaid recipients complain they don’t have enough information to determine which, if any, of the Managed Care Organizations best fits their coverage needs.

Flickr / Consumerist Dot Com Follow

Iowa’s Department of Human Services says United Healthcare has signed the most Medicaid providers of the four private Managed Care Organizations that are slated to take over management of the state’s Medicaid system on Jan. 1. United Healthcare has signed almost 66 percent of the state’s nearly 30,000 Medicaid providers, Amerigroup has signed 57 percent, WellCare 50 percent, and AmeriHealth Caritas 43 percent.

Iowa Public Radio / Sarah Boden

The Department of Human Services says it is not sure exactly how many of the nearly 30,000 Medicaid providers in Iowa have signed with at least one of the four for-profit companies that will take over Iowa’s Medicaid management on Jan. 1. This lack of information was one of the points Democrats used in a failed effort to delay the transition during Monday's Health Policy Oversight Committee meeting.

"I'm a little disappointed in the numbers you're giving me," says Rep. John Forbes of Urbandale. "Twenty-five days before this goes live. I have some concerns about that." 

Flickr / Tyler

At the Iowa Taxpayers Association's annual symposium on Friday, elected officials discussed Medicaid and the program's transition into management by four private, for-profit companies. The change is scheduled for January 1st, but many say this is a rushed deadline. 

State Senate Majority Leader Mike Gronstal, a Democrat from Council Bluffs, says he anticipates that during the next legislative session, a lot of focus will be devoted to resolving Medicaid-related issues. 

Photo by John Pemble

Gov. Terry Branstad says the state will move forward as planned with the January 1st deadline for Medicaid privatization in Iowa. That’s despite last week’s recommendation from Administrative Law Judge Christie Scase that the state dismiss one of four contracts it awarded to for-profit companies to manage Iowa’s Medicaid programs.

Photo by John Pemble / IPR

The Branstad administration is planning to shift Iowans who benefit from Medicaid to private management on Jan. 1, a move that would impact more than 560,000 recipients.

The governor contends that private management companies can offer more efficient service and save money, while those who rely on the program are worried, including Iowa City resident Heather Young.

“My husband and I are doing everything we can to keep the ship afloat," Young says. "Even with our best efforts, if this thing goes through, this ship is going to get torpedoed."

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Iowa Department of Human Services announced four private companies that will manage the services of Iowa’s $4.2 billion Medicaid program. Des Moines Register Newspaper Investigative Reporter Jason Clayworth took a look at some of the past problems that each of the four firms have faced in the past.

“What we found was for each of them was a series of deep problems with either mismanagement or fraud,” Clayworth says. “Some of them resulting in hundreds of millions of dollars in fines or settlements paid.”

Clay Masters / IPR


Brenda Hummel's 7-year-old daughter Andrea was born with severe epilepsy. Like many children with significant diseases or disabilities, she has health insurance through Medicaid. Hummel navigated Iowa's Medicaid resources for years to find just the right doctors and care for her daughter. But now Iowa's governor, Republican Terry Branstad, is moving full speed ahead with a plan to put private companies in charge of managing Medicaid's services, and that has Hummel worried.

Clay Masters / IPR

Governor Terry Branstad’s plan to privatize parts of the state’s Medicaid system is moving forward. Medicaid is the healthcare program for low income Iowans; that represents $4.2 billion in state and federal spending.

Alex Smith for Harvest Public Media

If you’re in the market for fluorescent light bulbs, you might talk to Chris Smiley.

Jennifer Morrow

Since the passage of the Affordable Care Act, 110,000 Iowans have enrolled in Medicaid through the Iowa Health and Wellness Plan.  The income threshold for those eligible went from 100 percent of the poverty level, to 138 percent. 

CEO of the Iowa Hospital Association Kirk Norris talks with Morning Edition about how Medicaid expansion has affected Iowan hospitals. 

Clay Masters: It’s Morning Edition on Iowa Public Radio. Good Morning. I’m Clay Masters.

John Pemble / IPR

More than twenty states have refused to expand Medicaid under Obamacare, leaving many Americans below the poverty line with few health insurance options. Some states are coming up with their own low-income health plans which would give them some of the federal money set aside for Medicaid expansions while writing their own rules. Federal authorities approved Iowa’s alternative proposal. As Iowa Public Radio’s Clay Masters reports… the rest of the country is taking note. 

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   October 1 is an important milestone in the rollout of health reform. The new insurance marketplace – where Iowans can select health coverage – goes live on October 1st. Iowa Public Radio’s Sarah McCammon and Clay Masters have an overview of what to expect on the health exchange.

Sarah McCammon / IPR

 IPR's Clay Masters talks with Sarah McCammon who's on assignment covering business news for Marketplace. 

IPR would like to know what business issues are important to you, join our IPR Insight Network and lend your expertise and experience to our reporting.  

Photo by John Pemble

Iowa lawmakers are returning to Des Moines for a third week of overtime. The session was scheduled to wrap up May 3, but legislators continue to negotiate education reform, property taxes, Medicaid expansion, and other key issues.

Photo by John Pemble

Republicans in the Iowa House say they hope to  offer an alternative to Republican Governor Terry Branstad’s plan  for insuring  thousands of low-income Iowans.    It’s part of the negotiating  on health care, which is  delaying adjournment of this year’s legislative session.