Medicaid Forcing Big Changes

DES MOINES — The manner in which health care is delivered to more than a half-million low-income and disabled Iowans is undergoing a vast transformation. Proponents say shifting management of Iowa’s Medicaid program to private organizations will lead to better patient outcomes and reduced state costs. But many are concerned the change will upset patient care. “My biggest concern right now is that very vulnerable Iowans are going to find themselves not getting the services they need,” said Iowa Senate President Pam Jochum, a Democrat from Dubuque whose adult daughter Sarah has intellectual disabilities. The Impetus Iowa spends $1.9 billion each year providing Medicaid services to 560,000 residents, according to state data. The state says the costs of administering the Medicaid program are growing at an unsustainable rate — 73 percent since 2003 and a projected 21 percent over the next three years. A large driver of that growth, state officials say, is the Medicaid expansion the state agreed to in 2013 under the federal health care law.