CAPITOL COMMENTS: Democrats demand inquiry into Iowa’s privatized Medicaid fiasco

By Rep. Todd Prichard, D- Charles City

In January 2015, I was surprised to read that then Governor Terry Branstad had unilaterally decided to privatize Iowa’s Medicaid health system.  I, along with the rest of my colleagues in the legislature, was caught off guard by the dramatic change to one of the state’s biggest programs.  There was no legislative input, no oversight, and no check on the Governor’s decision to alter how over 600,000 Iowans receive medical services. Despite this drastic shift, Republican legislative leaders refused  to intervene, or even question their fellow party member’s decision.  They faithfully believed the Governor’s promises that this would save money and continue to provide a high level of service.  Unfortunately, the new system hasn’t delivered on either of these promises.


In the time since this privatization move, both patients covered under the Medicaid system, and doctors and clinicians who provide services have struggled.  Patients have had to fight the Managed Care Organizations (MCOs) for service authorization.  Providers have to fight the MCOs for reimbursement for services provided.  The bottom line is that the system is in turmoil with no improvements in sight.


Perhaps if the legislature had asked more questions and executed its role as an oversight body, the original privatization rollout would have gone smoother.


Fast forward to present day.  Jerry Foxhoven, director of the Iowa Department of Human Services is now out the door due to the Governor asking him to misuse taxpayer funds.  By all accounts, he was a smart and competent director trying to make the Department of Human Services and its Medicaid program work.  He might be considered unique for his taste for West Coast hip hop, but nevertheless, his strong credentials and earnest willingness to make a flawed Medicaid system work speaks volumes to his competency.  For those of you listening to your favorite hip hop record, this is when we hear the needle scratch and the music stop. What is going on?


Once again we are witness to dereliction of legislative responsibility and an abdication of legislative oversight by Republican leaders.  Claims of illegal requests regarding the Department of Human Services, “too vague for us to investigate” according to Republican House Speaker Linda Upmeyer and Republican Senate Leader Jack Whitver.  Is it really too vague?  Or is it too close to home, having to investigate a fellow Republican Governor’s administration?


Transparency is generally viewed as a good thing in government.  It is good to let the public know what is going on.  This current administration and the handling of the Medicaid fiasco has been anything but transparent.  Rather, the response to Mr. Foxhoven’s claims smacks of either pathetic indifference or complicit cooperation in the hiding of troubling facts. We Democrats in the Iowa House demand an inquiry so that we can do our job of protecting the people’s interest.


If you have any questions, ideas, or concerns, I hope you will reach out.  You can reach me at or 515-281-3054 at the State Capitol.

I look forward to hearing from you.