Illinois Lawmaker Raises Concerns About The Future Of Medicaid During Budget Impasse

Illinois Lawmaker Raises Concerns About The Future Of Medicaid During Budget Impasse

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The lawmaker who heads up the Illinois House committee that budgets money for Medicaid said he’s concerned that some major health care providers are already scaling back coverage for poor people due to the ongoing budget impasse. 

As first reported by WBEZ, more than two dozen doctors, health care providers and insurance companies last week warned a federal judge in Chicago that they may stop serving hundreds of thousands of poor patients in Illinois. In court documents, the group said the state government continues to delay its court-ordered Medicaid reimbursement payments, and that could force Medicaid patients to find other doctors. 

Aetna Better Health said the state owes it about $650 million in Medicaid reimbursements, dating back to October. Meridian Health Plan of Illinois said it was owed $557 million. Family Health Network was owed more than $213 million, according to the affidavits.

“Now it’s getting so bad we’re seeing Fortune 500 companies, some of the largest corporations in the world, saying this lack of stability and the inability of the state of Illinois to get its financial house in order is causing us to think about continuing our relationship with the state,” said State Rep. Greg Harris, D-Chicago, who chairs the Appropriations-Human Services Committee in the Illinois House of Representatives.

In Illinois, doctors who serve low-income Medicaid patients are reimbursed through the joint federal-state health care program. That money sometimes flows through managed care organizations — or MCOs — such as Aetna, Meridian and Family Health Network.

According to their contracts, those groups do not have to reimburse doctors or health care professionals if the state is late in paying them. Up until recently, those MCOs had taken the financial hit anyway on behalf of the doctors. But the affidavits filed last week show the state’s slow payments are having a cascading effect: Meridian and Family Health Network have started delaying reimbursements to doctors to the point that health care organizations are now ending their Medicaid contracts.

There are more than 3 million people in Illinois enrolled in Medicaid and the Children’s Health Insurance Program as of February, according to federal data. That’s roughly a quarter of Illinois’ population, which the U.S. Census Bureau last year estimated was more than 12.8 million. 

At the start of the impasse, U.S. District Court Judge Joan Lefkow ordered that the state continue to keep Medicaid money flowing, regardless of whether lawmakers and the governor had passed a budget. In Friday’s court filings, the health care providers argue the state has been so tardy in paying up that it’s now in violation of that order. A court hearing is scheduled for May 10.

“I think that (the) Medicaid program has counted on them to be their bank and essentially pay out money to providers and the hospitals and pharmacies, and they’re saying, ‘Enough. We may not do this much longer,’” Harris said.

Harris repeated a common refrain for the past 22 months as a solution to the group’s concerns: The legislature and the governor should pass a budget. But those health care organizations aren’t counting on that.

Around the time the health care providers filed their affidavits in court, the Illinois comptroller released $800 million to pay health care organizations, though that’s only a third of what they’re owed, according to the office.

Tony Arnold covers state politics for WBEZ. You can follow him at @tonyjarnold.