November 22, 2015
Statement by Senator Joe Bolkcom, member of the Legislature’s Health Policy Oversight Committee
NUMBER ONE: Governor Branstad, you have consistently claimed that using private companies to manage Medicaid services will save money and improve care. Do you have any evidence to support your claims? Are you aware that your claims are not supported by the most comprehensive study of Medicaid managed care. The 2012 study by the respected Robert Wood Johnson Foundation concluded that:
“There is little evidence of national savings from Medicaid managed care, but a few states have had some success. The states that did realize cost savings were more likely to be states with relatively high reimbursement rates under fee-for-service.*
“Medicaid managed care has had mixed success in improving access to care. There is some evidence of increased likelihood of a usual source of care and reduced emergency department visits, but pregnant women were generally no better off under managed care then in fee-for-service.
“Quality of care in Medicaid managed care has not been well studied, making it difficult to compare quality in fee-for-service to managed care. This is surprising given that states require performance measures for all managed care plans.” http://www.rwjf.org/en/library/research/2012/09/medicaid-managed-care.html
NUMBER TWO: Governor Branstad, are you aware that the state of Iowa’s per person cost for Medicaid care has stayed essentially the same for the last 10 years? Do you realize that overall increase in Iowa’s Medicaid budget is due to:
- An increased number of Iowans in the program thanks to Medicaid expansion; and,
- A cut in the percentage of costs picked up by the federal government due to Iowa’s comparative stronger economy when compared to other states?
NUMBER THREE: Governor Branstad, if federal officials decide to delay or reject your effort to privatize Medicaid in Iowa, will you abandon drop your push to cut annual state revenue by tens of millions of dollars by redefining the sales tax on consumable supplies without Legislative approval?
NUMBER FOUR: Governor Branstad, Iowa’s health care industry is a major employer which provides high quality services at relatively low cost compared to other states. Why aren’t you working with Iowa’s community health care providers instead of blaming them for your administration’s failures?
NUMBER FIVE: Governor Branstad, has any Republican legislator approached you and suggested that you delay this transition until your administration is better organized and the alleged benefits can be proven?
* Note: Iowa’s Medicaid reimbursement rates are relatively low.
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