Dozens of Iowans begged members of the Iowa Senate Human Resources Committee Wednesday to make sure the state provides extensive oversight of the three healthcare management companies that will soon manage Iowa’s Medicaid system. The federal government says privatization can begin April 1.

One of the dozens to testify was Brandy McDonough of Cedar Rapids, who says her son Carson’s disability requires 24-hour care. McDonough says due to Medicaid privatization, Carson’s longtime nursing provider will soon close. As a result, she says she may have to quit her job to care for Carson fulltime and the loss of income would cause her family to loss their house.

"I wake up every day, not knowing what is going to happen," says McDonough. "This is so scary...there's not a lot of options."

A key criticism of privatization is that without oversight from the state, companies will implement unfairly low reimbursement rates and create excessive administrative burdens that will drive providers out of business, or cause them to drop Medicaid clients. They also say companies will prioritize profits above client care.

The three companies—Amerigroup Iowa, AmeriHealth Caritas Iowa, and UnitedHealthcare Plan of the River Valley—all say that's not true, and that they both provide a quality services and care about their clients' wellbeing.

"All these companies care about is profit," says Steve Olman, who lives in an Iowa City group home. "Without Medicaid I will lose my place to live and my staff. I need them to help me do everyday things. Please don’t take my rights away, to live my life the way I need to and what’s comfortable to me."

Governor Terry Branstad says privatization will expand the number of doctors who see Medicaid patients, while keeping costs low.