Kim Reynolds keeps giving away the store to for-profit Medicaid managers

Governor Terry Branstad and then Lieutenant Governor Kim Reynolds promised endlessly that privatizing Medicaid would make the system more “sustainable.” The talking point became a crutch for Governor Reynolds whenever she faced questions about problems privatization has created for patients, caregivers, and health care providers.

The old state-run Medicaid system wasn’t sustainable, Reynolds told reporters again and again. The new system was becoming more sustainable, she claimed during all three debates against her 2018 opponent Fred Hubbell.

The latest reality check arrived on July 10. For the second year in a row, for-profit companies that manage care for hundreds of thousands of Iowans on Medicaid will receive more than an 8 percent increase in government payments.

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Auditor: Service cuts to some Iowans on Medicaid violate state contracts

State Auditor Rob Sand warned the Iowa Department of Human Services on June 26 that service cuts to two quadriplegic Iowans indicate that Amerigroup and UnitedHealthcare “have failed to comply” with their state contracts. Sand said the managed-care organizations (MCOs) have pushed both Medicaid recipients to move into assisted living, rather than meeting their contractual obligations to ensure members have access to covered benefits and adequate health care services.

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Iowa Medicaid oversight chief to be governor's new health policy analyst

Elizabeth Matney, who has led the Iowa Medicaid Bureau of Managed Care since the state began privatizing nearly the whole program in 2015, is leaving the Department of Human Services to become Governor Kim Reynolds’ health policy advisor, Matney’s LinkedIn profile shows. Her starting date is unclear; the governor’s office has not announced Matney’s hiring or responded to Bleeding Heartland’s inquiries on the subject. A DHS organizational chart dated June 17 still shows Matney as bureau chief for MCO Oversight & Supports, the state’s leading official for overseeing the private companies picked to manage care for more than 600,000 Iowans on Medicaid.

When the new fiscal year begins on July 1, the governor’s office will receive additional funding for staff, so Matney’s work for Reynolds may formally begin at that time. The governor’s previous health policy advisor, Paige Thorson, appears to be staying on as deputy chief of staff, meaning that new funds would be needed to pay Matney (the governor’s staff have not clarified that point).

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Iowa DHS director Foxhoven resigns; governor appoints Gerd Clabaugh (updated)

Jerry Foxhoven has resigned as Iowa Department of Human Services director, effective today, Governor Kim Reynolds’ office announced on June 17. The news release did not give a reason for Foxhoven’s departure. Staff for DHS and the governor did not immediately respond to questions including:

  • Did Reynolds request Foxhoven’s resignation? UPDATE: Foxhoven confirmed that she did. See update below.
  • Was the resignation related to UnitedHealthcare’s impending departure from the Iowa Medicaid program on June 30?
  • Was the resignation related to DHS negotiations with Centene/Iowa Total Care, which will begin managing care for hundreds of thousands of Iowans on Medicaid as of July 1?

  • What is the status of negotiations with the state’s negotiations with Centene/Iowa Total Care regarding the Medicaid program?

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