ARTICLE

Governor?s governing may provide clue to his future

Something inside me wonders if Terry Branstad wants to continue serving as governor.


That ?something? surfaced after some controversial moves from Branstad this past spring and summer. With the exception of closing half of the state?s mental-health institutes (which was devastating to mental health care), I am not here to judge whether the decisions were right or wrong, but a large portion of the electorate is having problems with three of his decisions.


In addition to the closing of the MHIs, the other two decisions were his veto of $55 million in one-time money to state school districts and privatizing the state?s Medicaid program.


I?ve heard whispers for over a year now that some expect him to resign before the end of his term, which is Dec. 31, 2017. The three aforementioned decisions give some validity to those whispers.


If Branstad did resign at the end of this year or in 2017, Lt. Gov. Kim Reynolds would be an incumbent if she were to run for office in 2018. All indications point to Reynolds at some time seeking the top post.


It?s also no secret that Branstad has been ?grooming? her for the post for five years. Never can I remember a governor and lieutenant governor making as many trips and appearances together. While there?s nothing wrong with that, I think Branstad wanted to ensure that Iowans were well-acquainted with Reynolds, giving her a hand up in her race for governor.


Since I have no experience with Medicaid and have no horse in this race, I didn?t pay a whole lot of attention to Branstad?s decision to privatize it. Then I read a Des Moines Register editorial. Now it makes no sense, particularly financial sense, which is the reason he said he was doing it. The Branstad administration said privatization would save the state $51 million the first year but there has been no explanation how the savings would be achieved.


Kind of sounds like closing MHIs would save the state money with no facts behind the claim, doesn?t it?


There are 560,000 Iowans on Medicaid and it is a $4.2 billion program. The state has operated the program for decades, meaning there was no interest in turning a profit or pleasing shareholders.


In addition, the state held down costs, reduced fraud and offered seniors less expensive alternatives to nursing homes. Insuring the average Medicaid recipient, the Register editorial claims, cost Iowans less than insuring the average Iowa lawmaker.


Now that the program has been turned over to four private insurance companies, those companies aren?t just interested in taking over Medicaid because they want to be good public stewards. Not only is profit the main motive, you can take it to the bank that costs will rise.


When the state managed Medicaid, administrative costs were four percent. Managed-care companies could spend as much as 15 percent on the same costs, the Register said.


Recently, a state official testified in court that the Medicaid savings figure was not based on a specific analysis of Iowa?s program, but is the midpoint of estimates from unidentified ?experts.? One of those estimates said the state would not save a cent.


The Register editorial also claims that Branstad received nearly $40,000 in campaign donations over the past few years from managed care companies.


So, the state chooses four companies with less than stellar records. According to the Register, the companies have faced hundreds of millions in fines and more than 1,500 individual sanctions in other states. Three companies were rejected that had no history of violations.


If the editorial is correct, and I have no reason to believe it isn?t, it just sounds like another of Branstad?s thoughts with little planning and foresight, and another one that is not good for Iowa.