Tag Archives: Governor Quinn

Illinois begins audits and cuts to Medicaid. Rationing of care begins.

On July 7, 2012 the Illinois Tea Party broke down the ‘good’ and ‘bad’ parts of SB2840 and it’s amendments as well as HB5007. Together, these two pieces of legislation comprise what Governor Quinn refers to as ‘Medicaid Reform’. Whilst there was and still is genuine concern over the fiscal impact of Illinois expanding Medicaid nearly 2 years before the rest of the country. There was some good in HB5007. Specifically, the implementation of what most other state Medicaid programs already had in place for years. Namely, a TPA – Third Party Administrator.

The role of this TPA is to audit Illinois’ Medicaid program by verifying each year if current Illinois Medicaid recipients are still:

1.) Living in Illinois.
2.) Still living (not dead)
3.) Making the same income they were when they first qualified. If their income levels have increased rendering them no longer eligible, they are to be purged from our Medicaid rolls.

This is a very good thing since a pharmacist from another state recently stated during testimony that “some of our best customers are on the Illinois Medicaid program.”

The results of the first audit of Illinois’ Medicaid rolls are shocking indeed. According to the Chicago Tribune: Of the first 20,500 recipients screened by an outside contractor, the auditors recommend that 13,709 be removed from the rolls. Yes, that’s two-thirds of the first group screened, flagged as ineligible to receive their current Medicaid benefits. How so? In some cases, the recipients make too much money to qualify. In other cases, they don’t live in Illinois.”

Later in the same article the Tribune states: “Full stop. You may ask, as we do: Why didn’t state officials pluck this low-hanging fruit long ago?If Illinois officials knew, or suspected, that thousands of people were improperly receiving Medicaid coverage, why didn’t they act years ago to save hundreds of millions of taxpayer dollars?”

Since Julie Hamos – Illinois Department of Healthcare and Family Services chief – is quoted in the article as ‘doesn’t yet know‘. The Illinois Tea Party would like to clear up this mystery for her.

During Democrat Governor Rod Blagojevich’s Governorship, our Illinois Medicaid program was expanded illegally without legislative approval. Adding to the rapid bankruptcy of our Illinois Medicaid program was the fact that under Blago’s Governorship, legal residency status was not required on the Illinois’ “All Kids Covered” Medicaid application. Understand that when we use the term legal residency we are referring to U.S. citizenship. It took an investigation conducted by former Chicago Tribune reporter Dennis Byrne to determine just how many illegal immigrants were enrolled on our “All Kids Covered” program. The shocking answer was 75%.

Whilst the Illinois legislature is to be commended for finally implementing a TPA. They are still ignoring one of the largest drains on our Illinois Medicaid program. One that is a clear violation of Federal law. Namely, the 77,000 illegal immigrants who are still enrolled on our Medicaid program. None of which will be removed under Quinn’s ‘Medicaid Reform’ bill or any other legislation proposed.

According to Kaiser Health News the cost to cover just emergency treatment – much of it related to delivering babies – for more than 100,000 illegal immigrants is a $2 billion drain on the federal Medicaid program annually.  This being the case, one must ask. Why is there not a number 4 question added to the above TPA discovery process which asks: Are you a U.S. citizen?

By allowing thousands of illegal immigrants to stay on Illinois Medicaid program, lawmakers are disenfranchising Illinois residents who are not only legal U.S. citizens but are also medically fragile children. Part of Governor Quinn’s aforementioned ‘Medicaid Reform’ bill was $1.6 billion of top down, authoritative, across the board Medicaid cuts. $15 million of which pertain to medically fragile and technology-dependent children.

Equally disruptive and cold-hearted is the fact that Senate Bill 2840 eliminated Illinois’ Cares Rx program, which provides prescription drug coverage for 180,000 fixed and low income Illinois seniors. Seniors on fixed incomes of less than $16,000 have now lost their drug coverage. Community care and in-home care programs also faced severe cuts, resulting in the loss of services for thousands of seniors across the state. There is a word that properly defines this type of top down, authoritative, across the board cuts – rationing. And it’s about to get much, much worse.

Since 2000, Illinois Medicaid rolls have doubled, from fewer than 1.4 million people to nearly 2.8 million, or more than 1 in 5 Illinoisans. Starting in 2014, the President’s health care law is about to exacerbate this problem exponentially. According to various estimates, from 500,000 to more than 900,000 more Illinois residents will qualify for Medicaid when the PPACA (Obamacare) Medicaid expansion takes effect in 2014. This is because the PPACA expands Medicaid to childless adults for the first time ever. There are more than 15.1 million childless adults in the U.S. who will now be eligible for Medicaid. The PPACA also mandates that another 9 million Americans who already qualify for Medicaid but never enrolled do so beginning in 2014.

The ‘silver lining’ in Chief Justice John Roberts historic ruling on the PPACA last year was that states were now given the option to expand Medicaid. Since then many states have run the numbers and decided against expanding Medicaid. In contrast, Governor Quinn is moving ‘forward’ with Medicaid expansion with Senate Bill 26 which will voluntarily expand Illinois’ Medicaid program to nearly 350,000 additional individuals, who are between the ages of 19 and 64 with incomes under 138% of the Federal Poverty Level. The Dept. of Healthcare and Family Services (HFS) states the cumulative cost of this expansion could exceed $2.9 billion by 2020. The Kaiser Commission on Medicaid and the Uninsured estimates a similar number of $2.4 billion by 2020.

Worse yet, our Illinois Medicaid program already has unpaid bills piling up after lawmakers enacted a budget pushing $2.4 Billion of 2011’s bills into 2012. As they have been doing repeatedly for years now. In fact, on January 30, 2012, the Civic Federation released its “Budget Roadmap” for fiscal year 2012. In it, they highlight the fact that state officials now believe the Illinois Medicaid program will have between $21 and $23 billion in unpaid bills by 2017.

Purging illegal immigrants from our Illinois Medicaid rolls and implementing real reforms such as those proposed by the Illinois Policy Institute will save Illinois’ billions and insure that Illinois’ truly indigent and those with special needs are cared for. Until such reforms are implemented, Illinois Medicaid patients will continue to suffer from low reimbursement rates and long payment delays. Nursing homes and hospitals will continue to run out of money while they wait for reimbursement. And, doctors will continue to turn away poor patients and those with special needs.

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Governor Quinn, Illinois Democrats and Republicans plan to vote on implementing Obamacare nearly 2 years early!

Illinois Democrats & Republicans plan to vote on implementing Obamacare in our State as early as this Tuesday May 22, 2012.

As early as this coming Tuesday, May 22, 2012 Governor Quinn, Illinois Democrats and some Illinois Republicans will be voting to implement the most fiscally onerous part of Obamacare in our state nearly 2 years early. Namely, the massive expansion of Medicaid eligibility to nearly 800,000 new Illinois residents via a state based “Obamacare health insurance exchange”. Why are they attempting to do so now? Because, the U.S. Department of Health and Human Services (HHS) doled out another $181 million of your money in health insurance exchange establishment grants  this past Wednesday, bringing the total amount of money that the federal government has pumped into state efforts to craft the “Obamacare exchanges” to more than $1 Billion. Illinois’ share was $32.7 Million.

The Obamacare legislation mandates that States must demonstrate by Jan. 1, 2013, that they can operate an exchange (which opens for enrollment in October 2013) or that they manage a partnered exchange with the federal government. Otherwise, HHS will fully oversee the creation and management of a state’s exchange. Even though this timeline for this mandate is quickly forthcoming it is grossly irresponsible for Governor Quinn to threaten an executive order and subsequent vote to implement an Obamacare exchange when the Constitutionality of this legislation will be ruled on by the U.S. Supreme Court less than a month from today.

The following is an explanation of the failed rationale behind their attempt to do so and the reasons why all fiscally responsible, limited Government advocates must contact their local representatives tomorrow (Monday May 21, 2012) in order to inform them as to why they must vote to repeal this onerous additional burden to the tax payers of the state of Illinois as outlined, in part, in the following sections of the Obamacare legislation:

A.) 2001(b) of the Obamacare legislation outlining the “Medicaid Maintenance of Effort requirement (MOE)”

B.) Sections 1311, 1321 and 1401 of the Obamacare legislation which mandates Federally subsidized “premium tax credits” for “Obamacare insurance exchange” enrollees.

Under the Obamacare ‘MOE’, a state would lose all federal Medicaid funding if it makes even the slightest change to the current Medicaid eligibility standards that were in effect prior to the passage of Obamacare.

This essentially freezes our state’s eligibility requirements regardless of the impact on Illinois’ bottom line.  Not only is Illinois forced to keep eligibility at that level, but Illinois is also forced to raise payments to primary care physicians. Section 1202 of H.R. 4872 a.k.a. the Health Care & Education Affordability Reconciliation Act of 2010 (which was used to pass the PPACA) requires that Illinois increase Medicaid reimbursement rates for primary care physicians to the same level as the applicable Medicare reimbursement rates for years 2013 and 2014. At first this sounds like a good idea however, this requirement, along with the federal funding for it, expires on January 1, 2015. Leaving the state of Illinois tax payer holding the bill to maintain this new physician reimbursement or make drastic cuts.

It is crucial to understand that this new burden placed upon the Illinois tax payer is in addition to the already unpaid Medicaid bills piling up in Illinois after lawmakers enacted a budget pushing $2.4 Billion of last year’s bills into this year.  On January 30, 2012, the Civic Federation released its “Budget Roadmap” for the coming fiscal year. In it, they highlight the fact that state officials now believe the Medicaid program will have between $21 and $23 billion in unpaid bills by 2017.

Medicaid patients are already suffering from Illinois’ low reimbursement rates and long payment delays. Nursing homes and hospitals are running out of time and money while they wait for reimbursement. Doctors are turning away poor patients or making them wait weeks or months or even longer to receive care, just to keep their doors open.

What caused our Medicaid system to become so fiscally unsustainable? During Democrat Governor Rod Blagojevich’s Governorship, our Illinois Medicaid program was expanded far beyond simply providing health insurance for children of the poor (which was the original intent of the bi partisan Federal SCHIP bill). Blago expanded our Medicaid based state health insurance program to include 2 new programs that were designed to ‘supplement’ our “All Kids Covered”(www.allkidscovered.com) program (formerly “Kid Care”). These two new Medicaid based Entitlement programs (still in existence today) are called “Family Care”(www.familycareillinois.com) and “Mom’s & Babies” (www.allkids.com/pregnant.html). These programs go far beyond providing health insurance to children of the poor. In fact, they provide ‘free’ to nearly ‘free’ health insurance coverage for pregnant women and even the Father of a child who is enrolled on our “All Kids Covered” program. The program was also expanded to include coverage for those far beyond the existing Federal poverty levels. Adding to the rapid bankruptcy of our Illinois Medicaid program was the fact that under Blago’s Governorship, legal residency status was not required on the Illinois’ “All Kids Covered” Medicaid application. It took an investigation conducted by former Chicago Tribune reporter Dennis Byrne to determine just how many illegal aliens were enrolled on our “All Kids Covered” program. The shocking answer was 75%.
Source: http://articles.chicagotribune.com/2010-05-25/news/ct-oped-0525-byrne-20100525_1_uninsured-illinois-children-blagojevich-illegal-immigrants

Obamacare simply repeats the same mistakes already made by our now bankrupt (and deeply in debt) Illinois Medicaid program. However, it does so, on a national level. It increases Medicaid eligibility to 15 million childless adults and another 9.5 million who are considered ‘old eligibles’. Those who were always eligible but never applied and will now be auto-enrolled. It also increases eligibility for Medicaid to incomes as high as 138% above the federal poverty level. What does this mean in dollars and cents? A report released by the Centers for Medicare and Medicaid Services shows the impact this massive expansion will have: “This expansion, together with greater participation by individuals eligible under current rules, is projected to add 14.9 million people to enrollment in 2014 and 25.9 million people by 2020—26 percent and 44 percent, respectively, compared to pre-[Obamacare] estimates.”

This means that by 2020, Medicaid enrollment will reach 85 million, or approximately one in four Americans. This level of Government dependency distorts the original purpose of the Medicaid program, which was intended to serve as a safety net for only the truly indigent.

As a result of the expansion, the report shows, Medicaid spending between 2011 and 2020 will increase under Obamacare by $619 billion. The federal government will initially pay for most of the new spending, totaling $572 billion. But the expansion will increasingly strain state budgets as well, since the federal contribution decreases rapidly leaving the state tax payer holding the bill. In fact, this massive expansion of Medicaid will bring total state Medicaid spending to $2.3 trillion through 2020. Illinois’ share will be another $10 Billion by the year 2020. Source: http://illinoispolicy.org/blog/blog.asp?ArticleSource=4660

If Illinois lawmakers want to ensure our Medicaid program is both sustainable and protects the most vulnerable, they must redesign it from the ground up in a way that meets the needs of Illinois’ unique population. The first step is transforming it from the broken fee-for-service design into a sliding-scale premium assistance program paired with health savings accounts. This would ensure the most vulnerable would have access to doctors and specialists, would be empowered to make healthy and cost-conscious health care choices and would no longer be trapped in government dependency. It worked in the state of Indiana under Governor Mitch Daniel and it can work here in Illinois as well. Read about the success of Governor Daniel’s Medicaid reforms here: http://www.forbes.com/sites/aroy/2011/11/11/obama-administration-denies-waiver-for-indianas-popular-medicaid-reform/

What can you do to stop Governor Quinn, Illinois Democrats and those Republicans who support the implementation of Obamacare in our state nearly 2 years early? You can call your Illinois state representative and let them know that Illinois needs real Medicaid reform, not higher taxes and that you oppose Governor Quinn’s “Medicaid Reforms” and that you are against him establishing a state based Obamacare health insurance exchange via Executive order. Call the statehouse switchboard at (217) 782-2000 to be connected. Look up your legislator here. Again, they could vote as early as tomorrow or Tuesday.

Also call House Minority Leader Tom Cross. He seems to be ‘flip flopping’ and is ready to ‘cut a deal’. He needs to know that you value and expect principled leadership and rigorous policy reform. His statehouse number is (217) 782-1331. If the line is busy, call his district office at (815) 254-0000.

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