Medicaid Insurers’ Contracts on the Line in Tight Governor’s Race

One of America’s most competitive gubernatorial races could settle a heated argument over whether private insurance companies should run Medicaid. The race is in Iowa, whose Medicaid program has been plagued with controversy since 2016, when the state hired national insurance companies to manage billions of dollars’ worth of benefits. That shift was made by then-Gov. Terry Branstad, a Republican. With his executive order, Iowa joined most other states in privatizing the management of Medicaid, which covers healthcare for more than 67 million Americans with low incomes or disabilities. The arguments have resurfaced this year during the competition to replace Republican Gov. Kim Reynolds, who was Branstad’s protégé and continued contracting with private companies to manage Medicaid benefits. Zach Lahn, the Republican candidate to succeed the retiring governor, supports the practice. Rob Sand, the Democratic candidate, wants to end it. “It’s been a disaster,” said Sand, Iowa’s state auditor. “The number of complaints has been catastrophic.” Pros and Cons Supporters of privatization say the insurers, known as managed-care organizations, make Medicaid more effective and efficient. Criti...