- Associated Press - Wednesday, March 2, 2016

DES MOINES, Iowa (AP) - Iowa’s privatized Medicaid program would have more state oversight under a bill that advanced Wednesday in the Senate, a measure that aims to address public criticism over the transition away from a state-run system.

The Democratic-controlled chamber voted 32-18 for the bill, which would expand the state’s authority to review how three private companies handle the $4.2 billion program when they take over on April 1. It now heads to the Republican-majority House, where leaders have been vague about their support.

“The task before us now is protecting Iowans with tough, bipartisan oversight and accountability,” said Sen. Amanda Ragan, D-Mason City, before the vote.

The Medicaid program provides health care to roughly 560,000 poor and disabled Iowa residents. The legislation would direct the Iowa Department of Human Services, which currently oversees the program, to make specific improvements to consumer protections, data collection and payments to health care providers who offer Medicaid services.

Gov. Terry Branstad supports switching to a privatized system, saying it would provide better care and contain growing costs. Critics have challenged those points.

The transition, originally slated for Jan. 1, has been delayed by federal officials as they sought more signs of readiness from the state. Democratic lawmakers have been vocal in their disapproval of the switch, arguing that it’s happening too quickly and they’ve received complaints from constituents about limited information from DHS and the private companies. They also say there are concerns from health care providers about how they will receive reimbursements.

DHS has said it’s addressing those issues. Senate lawmakers say the bill would safeguard the program.

There was some Republican support in the vote, though many who opposed it did not speak publicly. The nonpartisan Legislative Services Agency estimates the legislation would cost about $5.5 million in the fiscal year that begins in July and more than $12 million in the following fiscal year. Ragan said a new estimate is needed following some changes to the bill.

House Majority Leader Linda Upmeyer, R-Clear Lake, has been vague about the House’s support.

“The legislature just needs to do its job. We have all kinds of oversight authority. We just need to do our jobs as we move forward, and I think things will work out just fine,” she had said Feb. 25. “But we’re happy to talk about ideas they might have around some of those issues.”

Branstad has also expressed some reservation. He noted that the state’s insurance division and a managed care ombudsman office can handle complaints. He later acknowledged the ombudsman program, an independent arm, has limited staffing and he would be open to expanding it. The bill proposes improvements to that system.

Still, the governor was hesitant about additional oversight.

“So we’re looking at more people that oversee the overseers, basically to manage the managers, and how much of that duplication do we want? And what will it cost?” Branstad said Monday. “Those are the kind of things you have to balance in determining whether this is good public policy.”

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