AmeriHealth Caritas exits Iowa's managed care program; Maine to vote on Medicaid expansion

Medicaid
CMS has granted Iowa's request to modify its Medicaid waiver. (Getty/juststock)

AmeriHealth Caritas Iowa will withdraw from the state’s privatized Medicaid program, the state announced this week.

The two other insurers that have been administering the IA Health Link program—Amerigroup Iowa and UnitedHealthcare Plan of the River Valley—have signed contracts with the program through fiscal year 2018.

Meanwhile, Iowa said it has put out a request for proposals to recruit an additional managed care organization to participate the program.

AmeriHealth Caritas, AmeriGroup Iowa and UnitedHealth have previously complained that the reimbursement rates they received were based on deeply flawed cost estimates provided to them before the project began. And some advocates have argued that the system reduces the quality of care for those with chronic or serious disabilities.

Also this week, the Centers for Medicare & Medicaid Services approved Iowa’s request to modify its section 1115 waiver. The plan is to eliminate retroactive coverage for Medicaid beneficiaries while they wait to be declared officially eligible for the program.

Hospitals opposed the change—which is expected to affect about 40,000 Iowans—arguing that it will place a significant burden on providers and limit their ability to care for Medicaid beneficiaries, according to the Des Moines Register. But the state said the move would save it $36.7 million.

Maine to vote on whether to expand Medicaid

Residents of Maine will vote on a ballot measure on Nov. 7 that will determine whether the state becomes the next one to expand Medicaid eligibility.

Maine Governor Paul LePage, a Republican, has been a staunch opponent of the measure and unsuccessfully sought to have the wording changed to describe Medicaid expansion as “welfare.” He has also vetoed the state legislature’s attempts to expand Medicaid five times.

If the initiative passes, an estimated 70,000 people in Maine will gain health insurance, according to the Associated Press.