Ten Years of Privatized Medicaid Has Left Iowa Families and Health Care Providers Struggling

DES MOINES, IA – Today marks the ten year anniversary since Iowa turned its Medicaid program over to private, for-profit companies — known as Managed Care Organizations, or MCOs. Back in 2016, Iowans were promised three things with the privatized Medicaid system: lower costs, more stable budgets, and better health outcomes. A decade later, the reality is clear: Iowa’s privatized Medicaid system isn’t working.

Before privatization, Iowa had one of the most efficient Medicaid systems in the country. But the results of privatized care tell a very different story. In 2020, as State Auditor, Rob Sand audited Iowa’s privatized Medicaid system and found a nearly 900% increase in illegal denials of care after privatization. After nearly a decade of privatization, Iowa families have been stuck battling red tape and bureaucratic headaches that never should have existed, while providers were forced to hire extra staff to chase down payments. 

Adding insult to injury, an editorial from the Des Moines Register highlighted how the state could save tens of millions of dollars annually by bringing Medicaid pharmacy benefits back under state control instead of handing them off to for-profit managed care companies. With the state facing a looming $1.4 billion budget hole, those savings are more important than ever. And now, partisan insiders are trying to make this failed system permanent — locking Iowans into a program that they know costs them more, delivers less, and prioritizes special interests over families.

“Everywhere I go, I hear from Iowans struggling with sky-high medical costs and a health care system that isn’t working for them. That’s a direct result from a decade of Medicaid privatization and one-party rule,” said candidate for governor Rob Sand. “Medicaid privatization has made things worse — illegally denying care, overburdening our health care providers, raising costs for families, and threatening rural hospitals. On day one as governor, I’ll begin the steps to reverse this failed experiment of privatizing Medicaid and work to expand access and bring down costs so more Iowans can get the care they need.”