Iowa’s Medicaid director says he can’t fully explain recent increases in what the state is paying for each Iowan enrolled in the government insurance program for poor, disabled and elderly Iowans.

Iowa Medicaid director Mike Randol presented a 36-page budget report to the Iowa Council on Human Services yesterday. A member of the council asked why a chart in the report shows costs went up more than 6.5 percent last year and are projected to increase 11 percent this year.

“I didn’t create that chart, so I need to go back and understand the background, understand the numbers behind the chart and understand the factors that could potentially be driving the increase,” Randol says.

Governor Kim Reynolds’ Administration recently agreed to pay the private companies that manage Medicaid 7.5 percent more, so that may account for part of the increased costs. Fred Hubbell, the Democrat who challenging Reynolds’ bid for a four-year term as governor, says it’s time for answers.

“Every time the governor or the governor’s office comes out with a number for what we’re spending on Medicaid, it’s a different number,” Hubbell says. “…There’s hardly any real disclosure about what’s going on in calculating the costs, the savings, the expenses.”

Hubbell has promised that if he’s elected, he will begin ending contracts with the private companies managing Medicaid patients’ care and bring the program back under state management.

Reynolds says the administrators she hired after becoming governor in May of last year have assured her that to control costs, private companies should continue to managed Medicaid.

“With the contract negotiations, we hold the managed care providers accountable,” Reynolds says. “I’m not going to continue to hear the stories I hear as I travel across the state.”

More than 680,000 Iowans are enrolled in Medicaid. Patients have complained about denied care. Providers say they aren’t being paid by the private companies and some have taken out loans to meet payroll.

(Additional reporting by Iowa Public Radio’s Katarina Sostaric)

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