Legislator says Medicaid plan may fail, worth the risk

A key legislator says the state’s new experiment with the government program that provides health insurance to nearly three-hundred-thousand Iowans may fail, but it’s worth taking a risk. Representative Danny Carroll, a Republican from Grinnell, helped craft the plan that expands the number of poor Iowans who qualify for Medicaid while forcing some to pay a small premium and encouraging regular visits to the doctor rather than making an expensive trip to the E-R. “You know change represents risk…however, you don’t improve much, you don’t make progress unless you’re willing to take a chance and take some risk,” Carroll says. “Failure is a possibility and there are some nervous folks…but we are going to give it our best.” Among the changes, Medicaid will now cover regular visits to the dentist. Governor Tom Vilsack says it’s a preventative measure. “If you access dental care, you’re going to save a lot of medical expense in the long run,” Vilsack says. “This legislation also provides for more personal responsibility.” Medicaid recipients will be encouraged to lead healthier lifestyles — to lose weight and quit smoking — and they’ll get a cash incentive if they succeed. The ultimate idea is that the state will spend less if people on Medicaid are healthier. “Iowa is going to allow the nation to learn a lot about what works and what doesn’t work in health care reform,” Vilsack says. The changes went into effect July 1st, and about a thousand Iowans who didn’t qualify for Medicaid before have signed up for the government insurance. About 15 percent of the state budget is spent on Medcaid. In order to streamline administration of the program, the state rented an abandoned grocery store in Des Moines, converted it to office space and put 25 state workers alongside three-hundred employees of private contractors hired to handle claims. Governor Vilsack says it’s an innovation that may be copied by other states. Vilsack says claims come into the mailroom, and they’re immediately converted into an electronic document that’s then shipped to the appropriate company that handles prescription drug claims, claims for doctor’s office visits or hospital claims. The state used to employ just one, out-of-state contractor to handle all Medicaid claims, but now pays eight different companies that agreed to put their workers in that single, state-owned building to save overhead costs.