Originally published in The Daily Iowan
While I was home over spring break, my family received the great news from the Department of Human Services that the cuts that had been made to my personal-care services through privatized Medicaid would be repealed. Before state Medicaid was privatized in the fall of 2015, most of the services I received were managed through Human Services, as was the case of other 600,000 disabled or poor Iowans. Once Gov. Terry Branstad’s brainchild took effect, however, the majority of those who had been managed by Human Services were instead managed by one of the three private managed-care organizations that the state had chosen, Amerigroup, Amerihealth Caritas, and UnitedHealthcare. These are for-profit companies that were now charged with placing the health and welfare of Iowans before their own moneymaking.
In December 2016, Amerihealth, the MCO I was on, told us that the rate I pay my personal-care assistants would be cut by a little over $3 per hour. We tried to appeal this but were told that an appeal could not be made. We asked for a meeting with Amerihealth; it refused. Human Services, Amerihealth told us, should never have allowed me to pay my helpers $13/hour to begin with. My family and I spoke with the state ombudsman, who encouraged us to try to get back with Human Services. Luckily, our application to return to the agency was approved. And just this past week, we were informed that Amerihealth’s reasoning for cutting my services was unsubstantiated.
Amerihealth also recently announced that it has been unable to negotiate new contracts with Mercy Health Network (think Mercy hospitals and clinics). This means that the 220,000 Iowans that are currently on Amerihealth could potentially lose services. Meanwhile, UnitedHealthcare faces a $2.5 million fine and is threatening to cut the hours of care that Iowans such as Jamie Campell receive substantially, as reported by the Des Moines Register.
I believe that health care is a human right. Even so, the occasional visit to the doctor or dentist may not seem like an essential staple in someone’s life. For many people with disabilities, however, when we’re talking about health care, we’re talking about services they need on a daily basis in order to live and participate fully in the community. In my case, for example, I require nearly around-the-clock care. When these services are not provided, or are not provided at an adequate level of quality, people suffer.
Quality health care for people with disabilities can be hard to find when making sure these services are funded is a headache. But it’s certainly not impossible, nor should it be something that we as a society let slide. When we rework the health-care system so that management organizations are in it to help others, not make a buck, the people whom these companies are meant to serve are being looked after. When we rework the health-care system so that personal-care assistants are making a decent wage, we then attract more professional applicants and have a lower a turnover rate. In my mind, it all comes down to what we place value on, and unfortunately, this is something that is not valued in our country.
It is time that the state Legislature recognize what privatized Medicaid in Iowa has become: a disaster. There are real people’s health and lives at stake, and if Branstad doesn’t have the decency to admit that his plan has failed and work to put something else in place, then whom is he really serving?