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Iowans caught in confusing, frightening, and frustrating Medicaid battle

Thousands of elderly and disabled people, along with more than one-third of the state’s children, face uncertain medical care when Medicaid is privatized ...

Starting March 1st, Iowans with Medicaid insurance will see a change in their coverage, as Iowa transitions to privatized Medicaid insurance.

Once the transition is made, some - of the 500,000 or more Iowans with Medicaid insurance - may need to look for a new doctor. That includes thousands of elderly and disabled people, along with more than one-third of the state's children.

It's why Chet Culver, the former Governor of Iowa, spoke to a crowd at United Neighbors in Davenport on Thursday. Culver is making stops across the state to warn people about the changes and take their concerns back to lawmakers.

On March 1st, Iowans with Medicaid insurance will move to a managed care plan offered by three private insurers, all based outside of the state. Those companies are called Amerigroup Iowa, Inc.; AmeriHealth Caritas Iowa, Inc.; and UnitedHealthcare Plan of the River Valley, Inc.

Amy McCoy, the Public Information Officer for the Iowa Department of Human Services, said all three of the private insurers have locations in Iowa now, but are originally based out-of-state.

Critics of the plan are worried once the state privatizes Medicaid, members may lose their doctors and some of their services.

"I think to unroll the plan and announce it in a year and a half for the thousands of people in Iowa that are on Medicaid is a little ambitious," said Liz Sherwin, Executive Director of Illinois-Iowa Center for Independent Living. "The people need to be educated on what the possibilities are and how the plans will affect them."

The state is mailing out informational packets to people with Medicaid but critics say they are confusing to read and don't give clear enough answers.

"These organizations in many cases have not spoken directly with people who will be the beneficiaries of their services," Sherwin said.

Right now, doctors bill Medicaid for their services. Once the transition is made, the three private insurers will take over control. Medicaid will give each of them a lump sum of money each month, a per-member per-month rate.

McCoy said managed care is a better option for the people of Iowa because it gives Medicaid the chance to hold providers more accountable and check on member health outcomes. She said it also will keep people from making repeated visits to the hospital.

"It’s called care coordination, and it’s really a focus on the members to make sure that they’re getting the kind of care that they need to make them healthier or more stable," McCoy said. "It makes better sense for the member, keeps the member healthier, to have better control of their condition, and it saves in cost to the program."

However, members worried they might lose their doctors said the switch may hurt them more than it helps.

"We have all of these specialists so we’re going to a doctor at least two or three times a month," said Norita Solt, a Bettendorf resident whose husband is disabled.

Solt said her husband has been disabled for the last four years and that she may need to apply for Medicaid coverage someday.

"Changing doctors is extremely stressful because you don’t know [them], they don’t know you," said Solt.

The Department of Human Services is still waiting for approval from the Centers for Medicaid and Medicare Services, McCoy said they expect to get that very soon.

For resources on navigating the new, Iowa Health Link, click here.

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