Privatized Medicaid's latest target: New transportation charges are leaving disabled Iowans in the lurch

Life for many disabled Iowans now features fewer outings, longer commute times and tighter living arrangements as a result of a state Medicaid policy change that affects their transportation to jobs and day services, a Des Moines Register investigation has found. The findings come less than a year after the Iowa Department of Human Services replaced a longtime "waiver" program used to pay for these transportation services. The change rolled the transportation payments into a new "tier rate" system that is supposed to be revenue neutral.But some companies and groups that provide services to disabled Iowans contend the new structure has cost them hundreds of thousands of dollars inrevenue, forcing them to take drastic measures that affect services to Medicaid recipients.The new tier rate payments have also hit some of Iowa’s public transportation agencies, raising the prospect of higher taxes.The results intensify anxieties and other challenges that people with disabilities sometimes face, parents and service providers said.