State Auditor Mary Mosiman. (file photo)

State Auditor Mary Mosiman has issued a report concluding state officials privatized the Medicaid program in 2016 “without establishing a reliable methodology for calculating cost savings.” Mosiman’s updated calculation shaves about $14.6 million off the savings estimate the Reynolds Administration released in May.

Governor Terry Branstad hired three private companies to manage Medicaid on April 1, 2016. He said it would save the state millions. Current Governor Kim Reynolds has kept Medicaid privatized.

The state auditor’s report reviewed two savings estimates released by the Department of Human Services in 2017 and one released this past May. Mosiman concluded the two 2017 estimates did not include all Medicaid costs, but the last estimate was “accurate based on the information available at the time.” Mosiman’s review includes new information from September 30 and November 7, 2018 — the day after the Election. The auditor’s calculation is the state will save $126 million during the current state budgeting year under privatized Medicaid.

Mosiman said the report will hopefully provide some clarity about program costs and savings.

“It is a very complex state program and therefore a very complex audit,” Mosiman told Radio Iowa. “We do have multiple Medicaid reports that we have issued over the last five years.”

This is the 14th report and all 14 are available on the state auditor’s website. It’s been nearly 32 months since Medicaid switched from a fee-for-service model to privately managed care. Mosiman cautioned that it will be harder to come up with accurate estimates of savings as more time passes.

Rob Sand, the Democrat who defeated  Mosiman’s bid for another term as state auditor, criticized her for not completing and releasing her review of Medicaid before the election. Mosiman said the data needed to complete the report wasn’t available until after the election.

“I said from day one that when the work was done, the report would be made publicly available,” Mosiman said today, “and that the report would be comprehensive and it would be verifiable.”

The state senator who asked for the report called it “a big pile of excuses with no good answers for Iowa taxpayers who are being ripped off.” Senator Pam Jochum, a Democrat from Dubuque, said the auditor’s report fails to show how much the out-of-state corporations still owe Iowa hospitals, doctors and other health care providers for unpaid bills. Jochum said there’s no evidence Iowa Medicaid recipients are healthier, which was one of the outcomes Branstad promised.