During her regular weekly press conference on Monday, Gov. Kim Reynolds said she is committed to transparency, but also came out in favor of cutting the amount of publicly reported information about how well the state’s controversial privatized Medicaid management program is performing.
The proposal to cut the amount information published about Medicaid comes one month after a report from the Iowa Department of Human Services (DHS), the agency responsible for overseeing Medicaid, showed that privatizing the management of the program that provides health coverage for approximately 600,000 Iowans has produced only a fraction of the savings that were promised when privatization began.
As first reported by the Associated Press, provisions to cut the frequency of DHS reports on Medicaid are included in HSB 632, a bill that makes several adjustments to how DHS operates. The bill also cuts the amount of information DHS is currently required to publish about the management of Medicaid.
HSB 632 was introduced last week at the request of DHS Director Jerry Foxhoven.
According to the AP, “The wide-ranging proposal surprised lawmakers, both Republican and Democrat, who worked to enact oversight provisions in 2016 when the program was turned over to private insurance companies, known as managed care companies or MCOs.”
Asked about the bill’s rollback of reporting requirements during her press conference, Gov. Kim Reynolds started her answer by saying her administration is committed to transparency. “Regardless of what we’re doing, we need to try to do everything we can to be transparent,” Reynolds said. But by the end of her somewhat rambling answer, she came out in favor of being less transparent if it makes the jobs of DHS employees easier.
And so, I believe with that as a guiding, you know, goal [transparency] that Director Foxhoven will work with the legislature to find the balance, so that we’re — you know, that he’s — I’ve tasked him with really taking a look at this agency and figuring out how we can make it better. How we can make it more efficient, how we can work with the workers that are, you know, everyday doing the best job that they can do to serve vulnerable Iowans across the state, and a lot of the processes that they’ve had are really making their job harder. And so, he’s really trying to look at every aspect of it, streamline it, make it so they can do their job in a more effective manner, while balancing reporting and transparency. That’s important, too.
In a statement to the AP last week, a DHS spokesperson said the reporting rollback was necessary because state official needed more flexibility when it comes to how and what they report. As an example, DHS is currently required by law to report on how much privatization is saving the state. The spokesperson said the department would prefer to report on “cost avoidance” instead.
In January, the DHS reported the program saved the $47.1 million in fiscal year 2018. When privatization of Medicaid management began in 2016, then-Gov. Terry Branstad claimed the change would save $232 million in FY 2018.
Following that report, Reynolds reaffirmed her support for keeping private companies in charge of managing Medicare, even though the program missed its savings target in FY 2018 by approximately 80 percent.
The 2016 change to Medicaid only privatized the management of the program. The funding for Medicaid — approximately $4 billion a year in Iowa — comes from the state and federal governments.