A new insurer is joining Iowa's Medicaid program. Here's what you need to know.
Later this week, Iowa will officially have three insurance companies managing its privatized Medicaid program.
New managed care contracts with private insurance companies to manage Iowa's $7 billion Medicaid program are set to begin July 1, marking a new phase in a program that administers benefits to about 750,000 Iowans who are low-income and disabled.
What's happening July 1?
On Saturday, state contracts with two insurance companies — Molina Healthcare of Iowa and Amerigroup Iowa — are set to begin. These private insurance companies, who signed four-year contracts, as well as Iowa Total Care, are tasked with administering approximately $7 billion in health care benefits to thousands of Iowans.
Molina is the only newcomer of the three. Amerigroup has been working with the state's Medicaid program since it was privatized in 2016. Iowa Total Care currently holds a managed care contract with Iowa through 2025.
More: Iowa's $7 billion privatized Medicaid program will work with 3 health insurance companies
What does this mean for Medicaid members?
Adding a third insurer to the safety net health insurance program means Iowans will have one more option when choosing their insurance carrier. July 1 will also be the first time since 2017 that three insurance companies will manage Medicaid benefits in Iowa.
According to the latest data from the state, 752,034 Iowans are on Medicaid and Hawki, or the Healthy and Well Kids in Iowa program. That does not include the additional 49,000 Iowans enrolled in the state's program under fee-for-service, which is managed directly by the Iowa Department of Health and Human Services.
In addition to more choice, Iowa Medicaid Director Liz Matney said an additional insurer will help the state improve health outcomes by increasing access to services, such as mental health care.
How many Medicaid members will be under each insurer?
Matney previously said the goal was to distribute members as equitably as possible among the three managed care organizations, but members still have the choice to switch to the carrier of their choice. That means the total membership distribution as of July 1 may change.
Starting July 1, Molina will oversee 205,181 of the roughly 750,000 Iowans under Medicaid and Hawki. Amerigroup and Iowa Total Care will administer benefits to 277,161 and 269,692 members respectively.
That total also includes 106,637 under the long-term supports and services waiver, which includes individuals who are disabled or otherwise need intensive, long-term services. The majority of those members will stay with the incumbent insurers, but Molina will take on 23,727 of those individuals as of later this week.
Michaela Ramm covers health care for the Des Moines Register. She can be reached at mramm@registermedia.com, at (319) 339-7354 or on Twitter at @Michaela_Ramm
This article originally appeared on Des Moines Register: Iowa is getting a new Medicaid insurer. Here are the highlights.
