DES MOINES — Just days after residents learned that a second insurance company was quitting the Iowa Medicaid program, House lawmakers introduced a spending bill that would give the program $150 million more to ensure all Medicaid obligations are met for this year.
Former Gov. Terry Branstad promised he would save the state millions of dollars when he signed an executive order that shifted the state program serving 600,000 children, poor and handicapped people — about 20 percent of the state's population — to a managed care system in which private insurers provide case management, arrange medical providers and pay the bills for those who qualify.
Thirty-nine states have managed care but only three — Kansas, Hawaii and Iowa — pay more than 80 percent of their Medicaid dollars to managed care insurance companies, according to The Henry J. Kaiser Family Foundation, a nonprofit health care policy research group. In most states, the government continues to manage at least a portion of the Medicaid eligible population, often those with chronic illness or long-term disabilities.
Medicaid reports show that while the disabled and elderly are just 27 percent of the Medicaid population, they consume 69 percent of the money. Huppert said managed care can achieve good results for some but not everyone.