Narrowing field of Medicaid providers would save Missouri money
The Kansas City Star
Missouri has traditionally been very generous to insurance companies that want to have a part of the managed care contracts for Medicaid recipients. Basically, any company that met the criteria was allowed to participate.
In the latest round of contracts, Gov. Jay Nixon’s administration limited the number to three. Officials say it was a cost-saving move and that makes sense. Fewer companies mean less administrative oversight and larger pools of patients to negotiate lower rates with hospitals, drug companies and other providers.
If you’ve been following the news, you know that the administration chose three providers, including Centene, which has not previously participated in Missouri’s managed care plan. Molina Healthcare Inc., which has been a participant and expected to continue as such, has gone to court after its bid was rejected. It wants a judge to order a re-bid.
Republicans, naturally, are crying foul, and point to $50,000 in campaign contributions that Centene has given to Nixon over the last two years.
It looks to me as though Molina might have a tough road in court. The bids were scored by a team of professionals, and Molina simply scored lower than the three selected insurers. As for the political angle, five-figure campaign donations are unfortunately very common in Missouri politics.
The legislature, though, might be a different story. Outrageously, Senate budget Chairman Kurt Schaefer, a Republican from Columbia, has slipped language into an appropriation bill saying that no money shall be allocated for Medicaid managed care programs unless the state has contracted with all providers who submitted a bid and met the qualifications.
What? That hardly syncs with the fiscal responsibility talk we’re always hearing from the legislature. According to this AP story, MoHealthNet Division Director Ian McCaslin has estimated the state will save $40 million in better rates by narrowing the field to three contractors, and an additional $16 million in administration costs over two years. Does the Senate budget chairman not want to save $56 million? Anyway, Schaefer’s move looks like a legislative infringement on the work of the executive branch.
Schaefer has received $1,250 in campaign contributions from Molina, but says that had nothing to do with his appropriations language.
In any case, Missouri’s open-enrolling period for Medicaid managed care began this week, and McCaslin has predicted bedlam if the decision on the three bidders is thrown out.
The entire scenario is a fascinating look at Missouri politics at work.