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Reynolds: Two Medicaid Management Companies 'Committed To Iowa' After One Departs

governor reynolds
Katarina Sostaric
Gov. Kim Reynolds speaks at the Iowa Capitol Wednesday, April 3, 2019.

Gov. Kim Reynolds said Wednesday she is confident Iowa will have two insurance companies ready to take on 425,000 poor and disabled Iowans after the state’s biggest Medicaid management company leaves.

Reynolds said she has “every indication” that Amerigroup will stay in the state and that Iowa Total Care will start up July 1 as planned. Contracts for the next fiscal year have not yet been signed. 

“They’re committed to Iowa. They’re committed to continuing to provide the services, and we’re going to get it done,” Reynolds said.

She announced Friday that she ended contract negotiations with UnitedHealthcare, the company that manages government-funded health care for 425,000 Iowans.

UnitedHealthcare maintains it is leaving because the state is underfunding Medicaid, but Reynolds said it’s because she would not compromise on holding them accountable with performance requirements.

“We had to agree to disagree when it came to UnitedHealthcare,” Reynolds said. “But they are committed to helping make sure the transition is smooth, to make sure that Iowans continue to get the coverage they deserve with as little disruption as possible.”

It’s the second Medicaid management company to leave the state. Iowa Total Care is scheduled to start July 1, to replace the other company (AmeriHealth Caritas) that left in late 2017.

Iowa Democrats have been criticizing the Republican governor because they say this shows privatized Medicaid management, which started in 2016, is failing. And they say it is causing chaos and anxiety for Medicaid patients.

“When it’s all done with too much too fast, you’re bound to hit some bumps in the road, and we hit some real big bumps and got stuck in the ruts,” said Sen. Tony Bisignano, D-Des Moines. “And it’s our constituents that have paid the price. And now they’re going to pay it again."

Sen. Pam Jochum, D-Dubuque, encouraged senators to take severely ill and disabled patients with long-term health care needs out of privatized Medicaid management.

“Managed care was never designed for people in our disabilities community,” Jochum said. “And I think all of you would agree after giving this three years that the disabilities community has not fared well under the privatization of Medicaid.”

A bill to that would do this has not advanced at the Statehouse this year.

“The same legislature that’s up there criticizing me also was saying it’s these corporations we’re paying all the money to and they’re not accountable to Iowans. Well, that was a piece of the negotiations also,” Reynolds said. “They need to meet certain expectations or they don’t get the full payment, and that’s not something they would compromise on, and it’s not something I would compromise on.”

Sen. Mariannette Miller-Meeks, R-Ottumwa, defended Reynolds Wednesday and said the governor took a “courageous stand” against an insurance company.

“I would ask us to work together with the governor as we have a new company coming on board, to try to work with our providers, to try our appeals processes that are in place, to give this a chance,” Miller-Meeks said.

Katarina Sostaric is IPR's State Government Reporter