From the article:
Conservatives liked the idea that private option patients would access their health care through insurance plans like Blue Cross and Blue Shield, as opposed to the traditional government-run Medicaid program, which many Republicans feel is inefficient and offers first poor-quality care.
Medicaid already utilizes private “health management” companies. For example, in Washington State there are seven. In addition the Medicaid recipient can pick which company he wants to be enrolled with. What’s the difference?