As the Trump administration and organizations like the Koch-backed Concerned Veterans for America push to privatize health care for U.S. veterans, it’s crucial to consider the experience of states that have privatized another form of publicly managed health care: Medicaid.

Two recent examples sum up the dangers of privatization: both Kansas and Iowa have suffered cuts in care, reduced far less costs than expected, and sacrificed oversight and transparency by handing their programs over to private entities. These changes have been devastating for many Medicaid recipients that once could depend on public provision for life-sustaining care.

This brief examines the experiences of Kansas and Iowa, and summarizes the problems they have encountered.


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