Iowa's Medicaid program transitioned to private management by three insurance companies on April 1, 2016. Patients and concerned citizens anticipated this transition would create numerous headaches and this has proven to be true. While the Branstad administration contends there are no problems and things are running smoothly, patient complaints say otherwise. The issues concern billing, provider networks, and transportation for people with disabilities. Members complain that services are being denied and they are not getting the medications they need. Only time will tell whether the issues improve or worsen for Medicaid patients. Over 90% of the state's Medicaid recipients are now covered by the private out-of-state companies that are administering the insurance care plans. Critics say that the privatization plan will result in reduced services for patients.