There's no mandate saying Gov. Kim Reynolds must go to the mat for her predecessor's blunders and wrong-headed crusades. But, yet again this past week, she defended former Gov. Terry Branstad's rushed privatization of Medicaid after it failed thousands.
It's 2017. Branstad is in China. Reynolds is no longer his lieutenant nor his political mouthpiece. She's governor. It's time she act like it.
On Tuesday, Reynolds had a few options amid questions about another significant glitch in the state's privatization effort. She could announce meaningful changes to the existing program. She could assert state authority and demand negotiations with Amerigroup. She could express doubts about an ill-advised privatization that everyone -- including federal officials -- tried to warn against.
She did none of those things.
Reynolds, instead, convened a media conference and dug in.
"It’s not perfect. I’ve never said it was perfect," she said. "I’m willing to put the time and the effort into making sure that Iowans get the care that they deserve in a managed and coordinated and more modern delivery system. I’m not going back."
Reynolds is in a tricky political spot. She was Branstad's heir apparent, both officially and politically. She's fulfilling his term and can't afford to turn friends into enemies. Her ascension when Branstad left for China provided her quasi-incumbency, which she will next year wield when she seeks re-election.
But make no mistake -- the events this past week are another signal of the failure that is Branstad's unilateral Medicaid privatization. They add to a mountain of evidence that suggest the 2016 switch-over was all about intellectually dishonest political ideology.
On Monday, beleaguered state health officials announced the return of Iowa's old-style, state-run, fee-for-service program for 10,000 Iowans.
They had no other choice. Last month, AmeriHealth, the largest of three firms contracted by the state to run its privatized health insurance for the poor and handicapped, opted to pull out of the program. No one was shocked. The firms have regularly reported tens of millions in losses and groused about the state's miserly pay rates. Suddenly, 215,000 Iowans found themselves without options for health coverage.
"No sweat," health officials initially said. Those affected would simply roll over into one of the two remaining providers: Amerigroup and UnitedHealthcare.
Amerigroup refused to expand access and pour more cash down the black hole that is Iowa's Medicaid program. UnitedHealthcare became the only option and didn't have contracts with major health care providers throughout the state.
So, grudgingly, state officials resurrected that which the Branstad administration sought to kill, at least for the 10,000 without options.
Neither the realities of policy -- nor the lives of hundreds of thousands of Iowans effected by it -- were the focus of Branstad's social engineering. Any governor, acting independently, would react with a modicum of urgency and concern.
Rightly, Democrats and health care officials went on the attack amid the latest revelation. The Republican social engineering wasn't working, they argued. The evidence -- the spike in denials for treatment, constant jerking around of people in need of care, the incessant calls from the three firms for more cash -- had reached a tipping point.
Branstad's baby -- perhaps the most significant political move of his second tour atop Iowa -- is a failure.
Reynolds' power derives from her association with Branstad. But her allegiance to her former boss has created a gaping blind spot, an inability to react to the dumpster fire he left her.
Until this year, it was Reynolds' job to represent Branstad. She toured around the state and shilled for him. She stood beside him as his tax cuts gutted state coffers. She touted his half-baked privatization of Medicaid.
Now, it's Reynolds' sits atop Iowa government. But, either by personal allegiance or political necessity, she's unable honestly grapple with Branstad's mistakes.