Med payments a mixed bag for state employees

By Mark Fitton
Illinois News Network

SPRINGFIELD — About 150,000 state employees, retirees or dependents are or soon will be stuck paying cash up-front for medical services, according to updated numbers from the Illinois Department of Central Management Services.

Those employees are covered via the state’s self-insured program administered by groups such as Cigna and HealthLink, CMS spokeswoman Meredith Krantz said Wednesday.

About another 213,000 people are covered in fully insured programs through agencies including Health Alliance, Coventry HMO and BlueAdvantage, Krantz said in an email to Illinois Network.

Those participants will be required to pay only copayments at time of service.

The fully-insured or managed-care plan providers made the decision to pay now and wait for state funds to come through, Strantz said, adding that was not by state request.

Krantz said CMS has exhausted its fiscal year 2015 revenues and, without an appropriation in place for fiscal year 2016, which began July 1, cannot make provider payments.

“Without a budget in place, there is no mechanism to pay healthcare providers,” Krantz said.

State employees first learned of the medical payment problem after CMS on Sept. 9 posted a memo on one of its Web pages.

First-term Republican Gov. Bruce Rauner and legislative Democrats remain locked in a budget impasse with the state now more than 75 days into fiscal year 2016.

Rauner complains the Democrats have sent him a spending plan that’s $4 billion heavier in spending than estimated revenue.

Democrats complain Rauner and the GOP have been unwilling to work with them on a plan until the governor gets movement on his own agenda items, which Democrats do not consider directly related to the annual budget.

In the meantime, without a budget illinois is spending at a clip that could see fiscal year 2016 expenditures outstrip revenue by $5 billion or more.

The only large piece of the fiscal year 2016 budget made law this spring was the budget for primary and secondary education. The rest of the spending is is attributable to items covered by continuing appropriations, such as debt service and pension payments, and to spending demanded by consent decrees and court orders.

State Rep. Raymond Poe, R- Springfield, said his insurance is through one of the self-insured plans, and he may soon feel the financial bite, as he’s headed to Houston, Texas, for a checkup with oncologists. Poe has been battling myelodysplastic syndrome, or MDS, a slow-growing cancer,

“I know first-hand what an interruption in service will be,” Poe said. The state’s financial crisis also disturbs him because of the high number of state employees and retirees in his district, he said.

Poe said there’s plenty of blame to go around, and both parties need to get to the table and work out a budget deal.

“It’s getting past the point of being excusable, he said. “We need to move forward … (and) if that means locking us all in a room until we settle this budget, fine.”

State Rep. Mary Flowers, D-Chicago, put the onus on Rauner administration.

“I think it’s, unfortunately, the governor really just trying to put pressure on us to do what he wants us to do by not paying our bills.”

Flowers, a longtime proponent of a single-payer healthcare system, said the current situation is another example of why the single-payer method needs further exploration.

Matt Murphy of Palatine, deputy GOP leader in the Senate, said Democrats in general and specifically House Speaker Michael Madigan, D-Chicago, need to accept their share of the responsibility for the budget stalemate.

“Sometimes when two people can’t get along, it really is just one of them,” said Murphy.

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