Reynolds dumped Medicaid adviser who asked tough questions

“It’s not certain to me that [my son] Matthew is safe with a Republican governor and a Republican legislature,” David Hudson told the Des Moines Register’s Tony Leys after Governor Kim Reynolds declined to reappoint him as co-chair of Iowa’s Medical Assistance Advisory Council. “And I say that as a lifelong Republican! Because I just don’t see the governor asking the right questions and doing the right thing for my son.”

By dumping Hudson and another council member who spoke out about problems related to Medicaid privatization, Reynolds has once again shown she is unwilling or unable to engage with facts on the ground related to Iowans’ health care.

Leys interviewed Hudson for this must-read scoop published on August 7. Earlier that day, the governor’s office announced four appointees to the council charged with advising the Iowa Department of Human Services director “about health and medical care services under the medical assistance program” commonly known as Medicaid. Hudson told Leys that his council co-chair, Iowa Department of Public Health Director Gerd Clabaugh, “encouraged him this spring to request reappointment, saying the council valued his insights as the parent of a disabled Iowan covered by Medicaid.”

Hudson repeatedly raised concerns about managed-care companies during the advisory council’s meetings, Leys reported. His own family battled with one of the private insurers over payments for his son’s care at home. He pressed a different company’s representative over refusals to cover in-home care for Todd Mouw. As the Register’s Jason Clayworth reported last summer, Mouw died a few months his MCO’s actions forced him to move to a care facility.

Hudson told Leys, “I felt that I was asking the questions the governor should have been asking […] I guess I pushed back too hard or something.” In a video clip posted on the Register’s website, he added,

I don’t see any moral courage in state government. The MCOs have a legal and moral obligation to provide services that are medically necessary. And when they make outrageous, indefensible decisions, someone in government should have the courage to say, “That is outrageous.” She’s not doing that.

A state ombudsman’s report and a major investigation by Clayworth have shown how “Iowa’s Medicaid maze is trapping sick and elderly patients in endless appeals.” Yet Reynolds continues to claim managed care will improve delivery of services to Iowans while saving the state money. She has discounted calls for a thorough audit of the program as politically motivated.

The other person Reynolds chose not to reappoint to the Medical Assistance Advisory Council was Jodi Tomlonovic. A former council member told Leys Hudson and Tomlonovic “asked hard questions that sometimes made people uncomfortable.”

The governor may have had additional reasons for wanting to replace Tomlonovic. In her role as executive director of the non-profit Family Planning Council of Iowa, Tomlonovic testified against a “personhood” bill and opposed Republican plans to defund Planned Parenthood by creating a state-run family planing program that excludes abortion providers. She publicly challenged GOP claims that other health care providers could easily duplicate services provided at Planned Parenthood clinics. She characterized a flawed state database as “difficult for a patient or potential client to use” to find alternate family planning services.

This year, Tomlonovic has pointed to lower state spending and sharply declining enrollment as evidence that the new family planning program is “not really working” and “not getting to people who need it.”

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