Insurance company insiders knew about Iowa's Medicaid privatization plans long before public

Governor Terry Branstad didn’t run for re-election last year on a plan to let private insurance companies manage health care for some 560,000 Iowans on Medicaid. He didn’t work with key state legislators to draw up his administration’s "Medicaid Modernization" plans. The governor’s draft budget, submitted in January, projected some $51 million in savings on Medicaid for the 2016 fiscal year. But key lawmakers like the chair of the Iowa Senate Health and Human Resources Appropriations subcommittee didn’t learn that four private companies would be selected to handle almost all Medicaid services until the Iowa Department of Human Services made its request for proposals public in February.

Recent accusations of bias and conflicts of interest, as well as allegedly inaccurate scoring of insurers’ proposals, have raised many questions about how the Iowa DHS selected the four companies now negotiating contracts to manage Medicaid for one-sixth of Iowans. Reports of campaign contributions by lobbyists and political action committees representing firms that sought Iowa’s Medicaid business prompted one watchdog to decry “pay to play” politics.

Those news stories point to a conclusion that isn’t getting enough attention: various insurance companies and their paid representatives knew what was coming down the pike long before the Branstad administration disclosed its plans to privatize Medicaid.

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No single issue is worth risking the Iowa Senate majority

Shortly before the end of this year’s legislative session, former State Representative Ed Fallon announced "political action" to stop the proposed Bakken Oil Pipeline. He warned that if the Iowa House and Senate did not approve a bill to block the use of eminent domain for the project, he would organize and fundraise "to help defeat one or two Democratic Senators and one or two Republican Representatives" who oppose the bill.

On June 5, the Iowa House and Senate adjourned for the year without passing an eminent domain bill in either chamber. Last week Fallon confirmed that he is sticking to his goal of defeating one or two majority party members in both the House and Senate, adding that he had already raised $4,500 toward the cause.

All I can say is, count me out of that political crusade.

Come to think of it, I have a few more things to say on the subject.

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Outgoing Iowa Utilities Board member slams Branstad's attempt to "appease" major utility

Outgoing Iowa Utilities Board member Sheila Tipton sent Governor Terry Branstad a scathing letter after not being reappointed to the three-member board last month, Ryan Foley reported yesterday for the Associated Press. Tipton defended a board decision from earlier this year, which greatly displeased MidAmerican Energy. She warned that by removing her and demoting Iowa Utilities Board Chair Libby Jacobs, Branstad was undermining state agencies’ independence "in order to appease MidAmerican Energy," thereby doing "a disservice to the citizens of this State."

Tipton also characterized Branstad’s recent personnel changes as  “unfair,” saying she had received verbal assurances in 2013 that she would be reappointed to a full six-year term if she accepted the governor’s offer to serve out Swati Dandekar’s unexpired term.

I enclose the full text of Tipton’s letter after the jump, along with a statement provided by the governor’s office, which defends the appointment of Geri Huser and denies that Tipton was promised a full term on the Iowa Utilities Board.

Even if Branstad or his staff did promise verbally to reappoint Tipton, the governor retains the right to change his mind. However, Tipton is unquestionably correct that the latest Iowa Utilities Board changes look like “an attempt to ‘bring the agency in line’ and to influence its future decision-making in a way that favors the utilities.”

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Weekend open thread: Where are they now?

What’s on your mind this weekend, Bleeding Heartland readers? This is an open thread. I’ve been catching up on some former state lawmakers, legislative candidates, and government officials.

As you may recall, Jeff Boeyink resigned this fall as Governor Terry Branstad’s Chief of Staff for a position with a lobbying firm. About ten days ago, the Iowa Ethics and Campaign Disclosure Board released an opinion at Boeyink’s request on how he can be involved in “government affairs” while Iowa’s two-year ban on former officials’ lobbying is in effect. More details on that opinion are after the jump.

After interviewing six candidates for a vacant seat on the Clive City Council, the remaining council members voted 4-0 to appoint Susan Judkins to the position. Judkins has lived in Clive since 2006. She was the Democratic nominee in Iowa House district 43 in 2012, losing to State Representative Chris Hagenow by just 23 votes. To my knowledge, no Democrat has announced plans yet to run against Hagenow in 2014.

Former Republican State Representative Renee Schulte lost her seat in 2012 to Art Staed, the Democrat she had defeated in 2008. Schulte is now consulting with the Iowa Department of Human Services on mental health reform. What was originally a six-month contract has been extended until the end of this year. Schulte recently ruled out running for Congress in the open first district.

Former Alaska Governor and Vice Presidential nominee Sarah Palin, unofficially known as “Half-Term” or “The Quitter,” was just in Des Moines for the Iowa Faith and Freedom Coalition’s fall fundraiser in Des Moines. Another Tea Party favorite, U.S. Senator Mike Lee of Utah, was a featured speaker. O.Kay Henderson posted the audio and highlights from Palin’s and Lee’s speeches at Radio Iowa. Throwback Phyllis Schlafly was honored at the Faith and Freedom Coalition event. How many Bleeding Heartland readers are old enough to remember Schlafly in her heyday, railing against the Equal Rights Amendment?

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Lingering question about Iowa Medicaid expansion debate answered?

During the past year, Republican governors have been split on expanding Medicaid as foreseen under the 2010 Affordable Care and Patient Protection Act. The U.S. Supreme Court made Medicaid expansion optional for states in its decision upholding most of the health care reform law. More than a dozen GOP governors were happy to opt out, but many prominent state leaders came around to supporting the Medicaid expansion, including Chris Christie of New Jersey, John Kasich of Ohio, Susana Martinez of New Mexico, Rick Snyder of Michigan, and even Jan Brewer of Arizona. Kasich has emphasized the moral imperative to give the poor better access to health care. Snyder has made a more pragmatic case, citing the over-use of emergency rooms by the uninsured and the burden that uncompensated hospital care places on businesses and insured individuals. Christie emphasized cost savings to New Jersey taxpayers.

Despite Governor Terry Branstad’s posturing against the health care reform law before and after the Supreme Court’s ruling, I figured he would eventually come around like Snyder and Christie did. Branstad used to be president of a medical school in Des Moines, so I thought he would be influenced by the Iowa Hospital Association’s case for Medicaid expansion. I expected him to return from a meeting with U.S. Health and Human Services Secretary Kathleen Sebelius saying he had negotiated a great deal for Iowa on Medicaid.

Instead, Branstad stuck to his guns throughout the 2013 legislative session, insisting on a more costly alternative that would cover fewer Iowans. I suspect that he promised to sign the final compromise only because Iowa Senate Democrats appeared unwilling to approve commercial property tax changes or education reform without a deal to expand health care access to low-income Iowans.

Branstad’s not a policy wonk. He’s always been strongly influenced by other people’s advice. So one question in my mind was, who kept telling him to ignore the Iowa Hospital Association, county officials and many other health care organizations and advocacy groups, which lobbied for Medicaid expansion?

This week Iowans may have gotten the answer.

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Brenna Findley will be Branstad's interim chief of staff (updated)

Governor Terry Branstad’s office announced today that the governor’s legal counsel Brenna Findley will serve as interim chief of staff until outgoing chief of staff Jeff Boeyink’s replacement is found. Having run Representative Steve King’s office in Washington for years, Findley is better-qualified for the chief of staff position than she is for her current job. She worked as an attorney only briefly after finishing law school and did not maintain an active license to practice in Iowa during her years on King’s staff. Branstad had to hire outside counsel to represent him in a high-profile lawsuit (at significant taxpayer expense), because Findley is a co-defendant in that case, accused of trying to strong-arm Iowa Workers’ Compensation Commissioner Chris Godfrey in 2011.

Branstad tapped Findley to be his legal counsel shortly after she lost the 2010 election for Iowa attorney general. He had promoted her candidacy heavily and even appeared in one of her campaign commercials, which he did not do for other GOP statewide candidates.

According to the press release I’ve posted after the jump, Branstad will name a permanent replacement for Boeyink sometime after September 18, when the governor is scheduled to return to Iowa from a trade mission to India and Japan.  

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