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Statehouse News: Feds halt Illinois Medicaid reform

July 20, 2011

By Benjamin Yount
Illinois Statehouse News

CHICAGO — The federal government says Illinois cannot ask Medicaid recipients to prove how much they earn or where they live.

The federal Centers for Medicare and Medicaid Services (CMMS), which manage these programs, told Illinois’ Medicaid managers in June that two of 15 reforms violate federal rules that prohibit states from changing criteria for those seeking Medicaid.

The reforms, passed earlier this year and signed by Illinois Gov. Pat Quinn (D), require Medicaid recipients to prove they are earning within 300 percent of the federal poverty level — $67,050 for a family of four — and live in Illinois.

U.S. Sen. Mark Kirk, R-Ill., said Illinois’ verification requirements are designed to prevent fraud.

“We are worried, because this will now cost the state of Illinois $800 million over (six) years,” said Kirk. “This is the fastest growing part of the Illinois budget.”

President Barack Obama’s (D) health-care reforms prohibit states from tightening Medicaid eligibility requirements that existed in March 2010. Illinois’ Medicaid reforms were passed in January.

Kirk said at a July 18 news conference that he is asking CMMS, based in Washington, D.C., to reconsider, because the state lawmakers’ intent was not to alienate people from seeking Medicaid. If his efforts fail, Kirk said he is willing to push Congress for legislation to change the rules.

State Rep. Patti Bellock, R-Hinsdale, who helped write the Medicaid reform package, said stopping fraud is the first step Illinois must take to contain the skyrocketing costs of Medicaid.

“Fifty percent of all births in Illinois (are) on Medicaid,” Bellock said. “One out of every three children in Illinois is on Medicaid, and one out of every five Illinoisans is on Medicaid.”

Bellock said that in 2006, Illinois spent $7 billion on Medicaid. This year, Illinois is poised to spend $15 billion, nearly half of the final $33.4 billion budget.

U.S. Rep. Judy Biggert, R-13th District, said that with all of the recent focus on federal debt and federal spending, the government should jump at any chance to save hundreds of millions of dollars.

“The state and the federal government have a partnership,” said Biggert. “It should not be a dictatorship.”

Biggert said she wants the Obama administration to reverse the ruling.

“I don’t think this is something that just happened,” Biggert said. “The other side of the aisle wants to make sure that everyone can be on these programs.”

Bellock added that Republicans and Democrats supported Illinois’ Medicaid reform laws, which were signed by a Democratic governor.

Mike Claffey, a spokesman for the Illinois Department of Health Care and Family Services, which runs the state’s Medicaid program, said, “While we are disappointed by the denial, we are pressing ahead to implement these reforms through other means that we believe will receive approval.”

Claffey said the state will use electronic databases to verify income and residency information.

But Bellock said she’s waiting for the other shoe to drop.

“We just have to wait and see about the rest of the reforms,” said Bellock.

Lawmakers passed a series of additional Medicaid reforms, namely increasing the amount Medicaid recipients pay, this past spring. Quinn signed the reforms in June. The federal government has not yet weighed in on those changes.

From the July 20-26, 2011 issue

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