Illinois Medicaid under reform

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SPRINGFIELD, Ill. (IRN) — Medicaid reform is halfway through the Illinois legislature.  The plan, which has long been a demand of Republicans, would make major changes to the state’s Medicaid program, and is designed to save the state $65.3 million in the first year.

The plan won approval in the Senate Special Committee on Medicaid Reform Wednesday, then sailed through the full Senate with a unanimous vote.  Some of the provisions include:

■ Moves more long-term care patients out of big institutions and into small community homes

■  Requires at least 50 percent of Medicaid patients have coordinated care by 2015  (where patients have one doctor making decisions and someone keeping track of all the care they receive)

■  Allows data sharing across state agencies, making it easier to identify fraud and ensure only Illinois residents receive Medicaid assistance

■  Requires one month of income verification to make sure only the truly needy can enroll in Medicaid (active verification rather than passive, in which the state assumes someone still qualifies until that person approaches the agency to say that he or she is no longer eligible)

■  Eliminates presumptive eligibility, except for pregnant women

■  Allows the Department of Healthcare and Family Services (HFS) to pursue more fraud cases and assess higher fines for violations.

The bill sponsor, State Sen. Heather Steans (D-Chicago), says Illinois has 2.8 million people in the program.  “We’re estimating that this bill in front of you will have at least $800 million in savings over five years,” she said.    

Critics believe Democrats are pushing reforms to encourage Republicans to be more willing to vote for pension borrowing or even a tax hike.  But State Sen. Matt Murphy (R-Palatine) says that’s not true.  “I don’t really think there’s any connection between them, and I never have, to be perfectly honest,” Murphy said.  “We need to do Medicaid reform because we need to do Medicaid reform.”   

This bill now moves to the House.

Reported by Melissa Hahn

Copyright 2011 Illinois Radio Network

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