Sen. Randy Feenstra

A key legislator says there are so many variables, it’s difficult to determine how much the state may be saving under the privatized system for Medicaid.

“It’s an unknown and we’ll probably never know if there were true savings or not,” says Senator Randy Feenstra, a Republican from Hull who’s chairman of the Senate Ways and Means Committee.

On April 1, 2016, private companies began managing care for the 560-thousand Iowans covered by Medicaid at that time. Governor Terry Branstad said the state would save about a quarter of a million dollars a year by ending state-run management of the program. Feenstra says it’s hard to compare what was in place two-and-a-half years ago with how the program’s operating today because of fluctuations in things like the number of Medicaid patients and the type of services and medications covered.

“That is such a gray area of how you look at whether we are saving money on Medicaid through privatization,” Feenstra says. “I think in the next few years we’ll have a better picture and I feel bad for (Department of Human Services director Jerry) Foxhoven trying to figure out and whether we are saving money or not.”

Legislators are “the first to hear” from patients who are being denied critical care, according to Feenstra.

“We’ve got to continue to keep our ear to the ground and make sure we hold those private companies accountable for good service,” Feenstra says. “Some of these are the most in-need people in our state who are getting these Medicaid services and we need to make sure they’re getting taken care of.”

Feenstra says small rural hospitals and clinics are complaining about late Medicaid payments. The new head of the state’s Medicaid program recently reported the state was saving nearly $141 million because the program had been privatized, but has not provided legislators with specific details about how those savings were achieved.

(Reporting by Jerry Oster, WNAX, Yankton; additional reporting by Radio Iowa’s O. Kay Henderson)