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ANKENY, Iowa -- When debating Medicaid, Fred Hubbell accused Kim Reynolds of failing to make necessary changes, and Reynolds accused Hubbell of promising more than he could deliver.

Reynolds and Hubbell, the Republican and Democratic candidates for Iowa governor, participated in the first of three televised debates on Wednesday night on the Des Moines Area Community College campus.

Hubbell criticized Reynolds for sticking with private management of the state’s $5 billion Medicaid program, which serves roughly 600,000 disabled and low-income Iowans.

Former Gov. Terry Branstad, a Republican, in 2016 handed off management of the health care program to private companies.

Many disabled patients and their family members have said that under private management, services have been reduced and the quality of care has suffered. And providers have said they are not reimbursed sufficiently or in a timely fashion.

Reynolds has said private management remains the best course while acknowledging some changes are needed.

During the debate, Hubbell said Reynolds has not made sufficient changes.

“It is not working, and it is in fact getting worse. So we need to do something much different,” said Hubbell, who throughout the debate told stories of Iowans who have had issues with the Medicaid program. He then said to Reynolds, “You’re promising more of the same.”

Reynolds said “the bulk” of Medicaid patients are getting the services they need and acknowledged improvements could be made.

And Reynolds accused Hubbell of pledging to reform Medicaid without offering how the state would pay any cost increase as a result of taking on a larger role in managing the program.

“And you’re telling everybody what they want to hear and not talking about how you’re going to fund the system moving forward,” Reynolds said to Hubbell. “You have no details or no answers about how you’re going to fund the system.”

Hubbell said he would take Medicaid back to a system where the state has control, not the private companies.

Just as Hubbell sought to use the debate to highlight Medicaid, a central issue of his campaign, Reynolds challenged Hubbell to release more of his tax returns.

Reynolds released 10 years of full tax returns; Hubbell released just cover sheets from one year’s worth of returns, from 2017 -- the same year he announced his campaign for governor.

“I don’t know what you’re embarrassed of or what you’re hiding,” Reynolds said to Hubbell.

Hubbell said the information he released included total income, deductions, and charitable contributions. Hubbell also said the tax information he released included sources of income -- the released information noted income from various boards and investments, but not which specific boards and investments.

“All of the information is out there,” Hubbell said, comparing his level of transparency to former Republican Gov. Robert Ray.

On Iowans’ taxes, Reynolds said if elected she would examine the state’s myriad tax credit programs and consider reducing the corporate tax rate, which she said would make Iowa businesses more competitive.

Hubbell called tax cuts implemented this year by Reynolds and the GOP-led Iowa Legislature “fiscally irresponsible” with federal trade negotiations impacting Iowa’s agricultural economy.

“The governor wants to take more money out of taxes. That means more money out of education, more money out of health care, more money out of infrastructure,” Hubbell said.

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Drake University political science professor Dennis Goldford said he would give Reynolds the edge but he would not call her the winner.

“The main response would be -- to be continued,” Goldford said.

Goldford said Reynolds was much more aggressive in her approach and Hubbell struggled to make his case for change in the face of that aggressiveness.

“If you look at her campaign ads, she’s been running as everybody’s Iowa kid sister and tonight it became evident that Iowa’s kid sister knows how to use a knife and a baseball bat,” Goldford said. “She was very aggressive, at times rudely so -- interrupting -- but very well-rehearsed, very well-prepared.”

Hubbell was at his strongest when he responded to her claims about his wealthy background by saying he’s not seeking to be governor for the money but rather to make things better for all Iowans, Goldford said.

“A challenger has got to make the case that, No. 1, something’s wrong with the way that things are run and, No. 2, I’m the person that can fix that,” Goldford said. “While he’s got a different laundry list of things, his focus is her fiscal mismanagement. He needs to emphasize that a lot more I think, a lot more sharply.”

But there were times, Goldford said, that Hubbell had “a deer in the headlights” look in the face of Reynolds’ aggressive style.

“She came out flipping a knife and swinging a baseball bat and so in that sense I think she somewhat more dominated the theatrics of the debate,” Goldford concluded.

Reynolds and Hubbell will debate again next Wednesday, Oct. 17, in Sioux City, and a third time on Sunday, Oct. 21, in Davenport.

Election Day is Nov. 6. Early voting in Iowa is underway.

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