Medicaid and Managed Care Action Alert

As many of you are aware, Systems Unlimited relies on Medicaid funds for a significant portion of our funding to support thousands of people with disabilities in Iowa through Supported Living, Employment and Behavioral Health Services. The Federal government covers approximately 57% of Iowa’s Medicaid costs. Congress has introduced significant changes to repeal and replace Obamacare with The American Health Care Act (AHCA). Of specific concern for Iowa is the condition in the AHCA that the per capita rates for Medicaid would be based upon spending at 2016 levels. States like Iowa, that have been careful about keeping costs down, will be penalized because the rates will be permanently stuck at that 2016 level. You might recall that Iowa’s Governor underfunded Iowa Medicaid program in 2016 by 110 million dollars in anticipation of the savings that would come from the shift to managed care.

Only ten months into managed care in Iowa, these organizations have claimed hundreds of millions of dollars in losses from rates they say were set too low to cover the costs of care and prescription drugs. The AHCA will be using these same “low rates” for potentially years to come. In February, Systems Unlimited received a notice that our negotiated rates with AmeriHealth Caritas for Supported Living and Day Habilitation/Employment services would be reduced on April 1st to a weighted average floor. The resulting impact will be close to ½ million dollars lost annually to our agency. In response to this mid-year reduction, our agency is discussing strategies to further contain costs while minimizing impact to those we serve. However, these types of actions- lowering service rates to providers and freezing Medicaid reimbursement levels to states will eventually impact people with intellectual disabilities and mental health conditions. The ramification of these cuts will likely include: refusing to serve people with significant behavioral or medical needs, cutting costs by reducing staffing levels and scaling back staff training. States will be forced to put more people on waiver waiting lists that will result in emergency room treatment, longer hospital stays and jails will become more common service providers for people with disabilities.

What can you do? Click here for a toolkit put together by the Consortium for Citizens with Disabilities (CDD). It provides simple and easy steps to let your Federal and State representatives know that we must save Medicaid and stop cutting services to our most vulnerable citizens. If you’re not a social media user, the document provides a link to the contact information (email and phone number) of your representatives.

In advance, thank you for advocating for those we serve. If you have questions or comments, feel free to contact me at any time.

Casey Westhoff
Executive Director
Systems Unlimited Inc.