Private health insurers now manage Medicaid programs in 38 states, according to Kaiser Health News. However, studies and government reports have failed to prove this model improves care quality or generates greater cost efficiencies.
Here are five things to know:
1. Today, more than two-thirds of Medicaid beneficiaries, or more than 54 million recipients, get their benefits through privately managed Medicaid plans. Thanks in part to the ACA's Medicaid eligibility expansion, this is up from less than 20 million people in 2000.
2. States pay Medicaid insurers about $300 billion each year to manage the benefits, up from $60 billion a decade ago. But when privately run Medicaid programs are reviewed by regulators, lawmakers and auditors, managed care insurers often can't account for their dollars spent or ensure necessary care is administered and provider networks aren't too narrow, the report states.
3. A lack of oversight may be part of the issue. Andrew Bindman, MD, former director of the Agency for Healthcare Research and Quality and a professor at the University of California-San Francisco, told KHN: "We haven't been holding plans to the level of scrutiny they need. This system is ripe for profit taking, and there is virtually no penalty for performing badly."
4. The stock price of one private Medicaid insurer, Centene, climbed 400 percent since the ACA's Medicaid expansions took place. Centene CEO Michael Neidorff earned $25 million in 2017, the highest among any health insurance CEO, according to KHN.
5. In California, two of the state's most profitable insurers, Centene and Anthem, received the poorest quality scores, the report states. Commenting on California's managed Medicaid program and its inefficiencies, Carolyn Yocom, a healthcare director at the Government Accountability Office, told KHN: "You simply cannot run a program this large when you can't tell where the money is going and where it has been."
For the report, click here.