Governor signs Medicaid Expansion Bill, Cook County program offers big lessons

July 22, 2013

(Photo courtesy of Matt Blake)
A billboard advertises CountyCare. Many considere CountyCare a test drive of Medicaid expansion.

Illinois Governor Pat Quinn signed a bill Monday that will make up to half a million uninsured residents eligible for health care coverage through Medicaid Expansion. The expansion is part of the Affordable Care Act and will kick-off in about six months. But Cook County residents have already gotten a taste of the program through a pilot called “CountyCare.”

We spent an evening with Heartland Alliance healthcare outreach workers to see what some of the big lessons from CountyCare have been so far. You can read them below, or walk through one applicant's process in the audio above.

Lessons from CountyCare:

1. Importance of outreach and education:  People who’ve never had health care before often don’t know how to use it.  Healthcare workers at a local outreach shelter said that many rely solely on emergency rooms.  The National Institute of Health estimates about 14 to 27 percent of ER visits could be handled by a primary physician. That costs taxpayers big bucks and often doesn’t result in the best long-term care for patients.

Dr. Ram Raju, CEO of Cook County Health and Hospitals System said, “It is drilled into people’s minds for 80 years that they should receive care at the emergency room, our job is to change their opinion.”

Medicaid is hiring people to help newcomers learn how to use insurance.

2. Lack of dental and vision coverage: The biggest challenge most health outreach workers said they’ve faced with CountyCare is the lack of dental and vision care. Medicaid used to provide adult dental care in Illinois. But in 2012, in an attempt to cut costs, it cut adult dental care except for some emergencies. That cut will remain after Medicaid expansion.

Ed Stellon is the director of Heartland Health Outreach. “We want to get away from compartmentalizing the different parts of the body. Oral health care is related to health care. Often the manifestation of a larger health issue is first identified by a dentist in a routine check up,” Stellon said.

3. Long wait times for application approval: Many applicants and outreach workers complained about the gap between when an application was sent in and when it was approved.

“There are some people that it’s been taking 8 weeks and they have everything they need turned in. You know we have people with diabetes who haven’t been able to properly check their blood sugar,” said health outreach worker Cat Schwab.

Schwab says that the long wait times come from the demand. A staggering 74 thousand people have been recruited to CountyCare in just 6 months. The state recently tripled the number of staff who approve applications.  It expects to enroll 115 thousand people before the start of next calendar year, when Medicaid Expansion kicks in statewide.