A statehouse committee spent much of Tuesday hearing about what’s being called a massive change in how health care in Iowa is delivered to the poor and disabled.

On January 1, four private companies are scheduled to take over management of the state-federal health care program known as Medicaid which serves more than 565,000 Iowans. Iowa Medicaid director Mikki Steir is hearing not only from Medicaid patients, but from doctors, hospitals, clinics and mental health care providers who are trying to figure out the new system.

“We’re answering as many questions, no matter where they’re coming from, as quickly as we can,” Steir told legislators.

Under the current program rules, hospitals, doctors and other providers are paid for the services provided. Starting January 1, the state will pay a per-patient fee and some health care providers say they don’t yet know what that fee will be. Democrats on the committee tried to force a delay until July, but Republicans backed Republican Governor Terry Branstad’s plan to move ahead with the plan. Republican Representative Dave Heaton of Mount Pleasant accused Democrats of grandstanding.

“I think there’s politics in these positions through and through,” Heaton said.

Senator Joe Bolkcom, a Democrat from Iowa City, said this same committee will meet again to review progress on the policy shift.

“We going to continue to have a conversation about whether we’re ready or not and we’ll evaluate it then on whether we’re going to take another run at a delay,” Bolkcom said.

And Bolkcom said there’s also a lawsuit that could derail the plan. Companies that lost out in the bidding process are challenging how the state chose the four winning companies.

(Reporting by Iowa Public Radio’s Joyce Russell)