Medicaid and pineapple on pizza

This commentary was a collective effort by four people on the advocacy committee of the United Spinal Association’s Iowa chapter. -promoted by Laura Belin

Is pineapple on pizza acceptable?

This irrationally controversial question has divided households since the advent of Hawaiian pizza. Gordon Ramsay decisively says that pineapple has no place on pizza while Alton Brown is a staunch defender. How do we decide which reality cooking show host is the expert?

Odds are, you will choose an expert based on your pizza preference. This is called “confirmation bias.” We are all quick to ignore information that doesn’t confirm our bias and latch on to information that does.

This is exactly what happened last week when a Republican legislator took the words of disability advocates out of context on the Iowa Senate floor.

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Iowa Republicans choose not to look for overspending on Medicaid prescriptions

The Iowa Department of Human Services will not audit a practice that could be inflating costs for Medicaid prescription drug payments by millions of dollars a year.

State Representative John Forbes raised concerns after finding discrepancies on bills for some prescriptions his Urbandale pharmacy filled for patients served by Amerigroup, one of Iowa’s Medicaid managed-care providers. Earlier this month, House members unanimously approved Forbes’ amendment to the health and human services budget, instructing DHS to “audit all prescription drug benefit claims managed by a pharmacy benefit manager under the Medicaid program.”

However, House and Senate Republicans dropped that section from the final version of House File 766.

State Senator Mark Costello, who floor managed the health and human services budget in the upper chamber, claimed Iowa’s Medicaid director Michael Randol and an Amerigroup representative had told him the audit was unnecessary.

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Iowa Privatized Medicaid: It Has Been A Disaster. Here’s Why.

By Simon Davis-Cohen for Tarbell.org

This is a reprint from Tarbell.org, a news website pioneering journalism that reveals who runs America and empowers readers with solutions. Read this on Tarbell.org.

If you have any feedback on this piece, please contact Tarbell’s engagement editor, Danielle Keeton-Olsen, at danielle@tarbell.org.

In 2016, Iowa privatized Medicaid under then-Governor Terry Branstad. He was a founding member of the American Legislative Exchange Council (ALEC). “Obamacare” is often attacked by the David and Charles Koch-backed group that opposes government action in health care or the economy.

Branstad claimed outsourcing Medicaid would save the state and taxpayers money. However, Iowa has not been able to provide any data that shows privatization saved the state money. In fact, privatization is now costing Iowa money. (Branstad resigned the governorship in 2017 to become the U.S. Ambassador to China.)

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Elizabeth Warren is running to do the job

Dubuque Democrat Rachel Wall didn’t plan to commit to a candidate this early but “lost my own bets with myself” after seeing Elizabeth Warren in person last month. -promoted by Laura Belin

I will preface this piece by stating my only commitment for the 2020 cycle was to caucus for a woman. Some may say that is blind feminism, but it is the promise I made to myself. In order to normalize women running for all offices, I made that pledge.

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An army of misery forced to decamp with UnitedHealthcare's departure

John Morrissey is a longtime Des Moines resident who has investigated state spending increases, financial anomalies, and payment disruptions associated with Medicaid privatization in Iowa. -promoted by Laura Belin

The “he said/she said” controversy between an insurance company CEO and Iowa’s governor about why UnitedHealthcare decided to leave the state’s Medicaid program might make entertaining copy, but it doesn’t address who is going to manage the care of 420,000 Iowans left in the lurch.

Nor does it address whether the remaining company (Amerigroup) is adequately prepared to handle more members, and whether a new player poised to enter our state’s Medicaid market (Iowa Total Care) has the expertise to handle special populations in Iowa such as the elderly, disabled, and very ill.

It also doesn’t consider whether the state’s traditional fee-for-service Medicaid offering has the financial wherewithal to shoulder an even larger share of the enrollment and cost. Fee-for-service was held over from the old state-run program when most of the Medicaid program was privatized in 2016. The fee-for-service program pays the claims of Iowa’s sickest and most frail Medicaid members, which the for-profit managed care organizations (MCOs) don’t want or can’t handle.

The Iowa Deparment of Human Services (DHS) did not respond to a request for comment on these issues.

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