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Something strange is going on with Iowa’s Medicaid program, and it could be the hottest issue in that state’s governor’s race this November.
The Des Moines Register reported on Friday about the ever-shifting estimates on how much money the state is saving since it moved its Medicaid program in 2016 to managed care — the widely used system where private, though often nonprofit, health plans are paid by the state to run their Medicaid programs and administer benefits.
First, according to the Register, the Iowa health department reported that the state was saving $141 million (out of a $5 billion budget for about 600,000 enrollees) under managed care, without any further explanation except that it was a “projected annual range.”
Then they said it was a cumulative savings since April 2016, when the state switched over to managed care. Then they said it was for the current fiscal year.
Those are very different estimates. A single-year savings of $140 million would mean the state might be on track to save $280 million over two years. But if the $140 million is for two years, since April 2016, then the state is saving just $70 million a year.
Either way, the Register noted, these numbers are far below the $230 million that then-Gov. Terry Branstad predicted the state would be saving annually by now as he was advocating to privatize the Iowa Medicaid system. Yet they’re far higher than the $47 million the health department originally projected for this year.
Like I said, it’s strange.
Now Branstad is ambassador to China, and Medicaid managed care is overseen by his Republican successor, Gov. Kim Reynolds. She has upheld the program as a model of more efficient government. But she is going to face attacks over it in the November election, where she is favored but not quite assured of reelection.
Democrats will pick their candidate for governor in a June 5 primary. All three of the notable contenders — Fred Hubbell, a business owner who once worked for the state’s economic development agency; State Sen. Nate Boulton; and Cathy Glasson, a local SEIU leader — say they want to reverse the move to Medicaid managed care.