Had the pleasure of joining in on a virtual fundraiser for state senatorial candidate Chris Brase from Muscatine the other night. Brase is a former state senator who lost his seat in 2016. In his pre-legislative days, Brase was a fire fighter and paramedic. His life was dedicated to serving his community.
Like many activists, we would frequently attend the fundraisers held for candidates. Besides being a great time to renew acquaintances and make new friends, such gatherings were also a great time to talk about issues of the day. These discussions would help keep us sharp and up to date on issues that we just don’t seem to discuss much these days.
The domination of the airwaves and the internet by the craziness, buffoonery and criminality of the Trump administration just simply shoves most everything else into the background. The cruelty of the administration to the most vulnerable populations is incredible. So the cruelty by our own state government pales in comparison and is just buried beneath the daily drudge that is pile up these days.
During the discussion a question was asked about the possibility of returning the administration of the Medicaid program to the state. As noted, in the pile of daily sludge and drudge piled on our citizens by Trump and by the mishandling of the coronavirus crisis by Kim Reynolds, I (and I bet most Iowans) had nearly forgotten about the Medicaid “privatization: dumped on the state by then governor-for-life Branstad.
Just to summarize briefly, Branstad through executive moves took the administration of Iowa’s Medicaid program from a state agency that did it quite well and literally gave it to private insurance companies. The supposed reason was that private administrators would save the program money by plugging leaks where money was being spent not in accordance with the program.
Now, private administrators would have to save lots of money because their costs were something like 5 times the cost of the in house state administrators. The money to pay the extra costs for the private administrators would come out of program funds. Thus the extra cost would come by cutting goods or services from programs clients. But that money SHOULD HAVE be made up in savings.
The following are ought numbers and only for the purposes of illustration:
If I recall Iowa’s yearly Medicaid budget was $5 Billion. The administration was @3% of that or $150,000,000. Privatizing that administration raised the cost of administration to 15% or $750,000,000. That was a raise of $600,000,000. That is a huge chunk of money. As a reminder that extra $600 million was supposed to be made up through savings.
Now if you recall the savings never really materialized. So what happened was that services to clients started getting cut. These is a very vulnerable group of people who need the services. Often any cut in services results in major lifestyle reduction and possible threat to life. But that is where cuts were made.
Also the private administrators failed to pay bills to providers or would often pay only pennies on the dollar. This caused financial problems for providers, many of whom ended up losing their business or quit providing services to needy clients. In short it was a God awful mess.
And the administrators claimed they weren’t getting enough money. Through some behind the scenes negotiations the cost of administration rather quickly cretics up to the 20% range. Services continued to be cut and provider payments stayed spotty. Attempts to investigate the program were met with resistance from both the executive branch of the government and the administrators.
The transition has cost clients somewhere in the neighborhood of $850,000,000 that once went for services and goods. Now that money is simply increased costs for an unneeded middle man and is funded by cuts in goods, services and provider payments. Remember the numbers I am using are not the actual numbers but ballpark figures for the purpose of illustration.
This illustration is just to remind you that there are some serious state issues that should be faced and fixed. State voting laws need to be reformed to return to the concept of a few years back to encourage all citizens to vote and to make it easy to vote.
Who can forget the union busting that Branstad undertook unannounced early in his second round. Those changes made Iowa a much less desirable place to live and work.
And of course I have no idea what if anything the legislature could do to make Reynold’s horrible response to the coronavirus pandemic any better, but anything must be better than what she is dong right now.
All this to remind you that voting down ballot is a must this year. Also to remind you that the stats quo is a lot worse than the daily blather would indicate. Iowa needs change that only Democratic majorities in both legislative chambers can bring.