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Editorial: Switch to private Medicaid needs oversight

BY DI EDITORIAL BOARD | MAY 12, 2015 5:00 AM

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It’s an argument as old as the U.S. Constitution itself — how much responsibility should we give our government? As it is currently pertains to the state of Iowa’s transition to a privatized Medicaid system, the opinion is split.

Democrats are in favor of extensive government oversight to be involved with the switch, but Republicans are against an increased role of the state in these matters. Gov. Terry Branstad has voiced his concerns over how restricted government oversight will slow down the process, but it’s a particularly an unfounded worry; 39 U.S states have similar measures to manage the transition. And Iowa would join those preceding states in managing the costs associated with private insurance.

The biggest concern taxpayers should have is for this measure to be followed through in their favor. What an oversight commission is able to do is act as a benefactor for people when switching to a private insurance company.

Handing over the reins completely to insurance agencies to manage Medicaid instead of elected officials is problematic. Corporate interests are in play here, and the incentive to increase profit margins by elevating the price of insurance is not beneficial to the consumer. It will be a disaster for Iowans if an oversight committee isn’t available to manage costs.

Republicans are sticking to their stance, and it’s unclear why. The worry is that increased services will delay the transition, but if the development of an oversight commission helps save citizens more money in the long term, it’s justifiable. The amount of money saved by switching to private insurance is estimated by Branstad to be $51 million, but the Democrat-controlled Senate’s plan to limit profits for insurance companies via committees could more than double that —a whopping $108 million in state savings. Republicans argue there is no way that delaying the transition could ever amount to that, firmly holding to a quick-action strategy that appears shortsighted as it is misguided.

The Daily Iowan Editorial Board believes that Iowa should learn from the mistakes made by Kansas, a state that went the route of giving insurance-management responsibility to private companies instead of government bureaucracies.

Advocates for disability rights in the Kansas have noted failures in providing sufficient care for vulnerable patients. The number of people in the disability-waiver program has dropped by 14 percent, which has caused many improperly guided individuals with disabilities from receiving the services they require. Simply because patients were not guided by an independent advocate, they were bumped off waivers and waiting lists.

There are currently 560,000 Iowans who receive insurance benefits through Medicaid. Those Iowans deserve a program that works for them, not for insurance companies.


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