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Potential Resistance to Request for Cook County Medicaid Waiver

Health & Medicine Policy Research Group (HMPRG)
February 2, 2012

Earlier today we posted that the Illinois Department of Healthcare and Family Services submitted to CMS a request for a Medicaid waiver to expand coverage this year to people who would otherwise become eligible in 2014.  Before this waiver application is granted, the Illinois legislature must pass an exception to the Medicaid expansion moratorium passed last year. The notice below was just received and illustrates the opposition in the General Assembly to overriding last year’s moratorium.  We will keep you posted on the status of the application and the progress in the General Assembly as we hear.

Righter, Bellock: Administration Needs to Implement Medicaid Reforms, Drop Plans for Cook County Expansion

 Springfield, IL…..State Representative Patti Bellock (R-Hinsdale) and State Senator Dale Righter (R-Mattoon) today called on the Quinn administration to implement cost-saving Medicaid reforms already passed into law and to drop plans to seek a Medicaid expansion for Cook County.

“Governor Pat Quinn yesterday barely touched on the subject of Medicaid reform in his State of the State speech. Meanwhile, we have hundreds of millions of dollars in cost saving reforms we worked hard to pass into law that his administration has failed to implement, including the Medicaid Payment Recapture Audit that estimates say could recapture up to 10% of our total Medicaid costs through identifying fraud and other errors,” Bellock said. 

Other Medicaid reforms passed into law but not implemented include P.A 96-1501 requiring income and residency verification for Medicaid applicants; and P.A. 96-941 authorizing the Department of Health Care and Family Services to develop and implement an Internet-based transparency program that would be helpful in tracking provider fraud and improve service.

“Last year lawmakers passed bipartisan Medicaid reform that placed a moratorium on the creation or expansion of Medicaid programs, and established what I’m sure most people in this state would consider common sense income verification measures,” said Righter. “So I was dumbfounded to learn that even as the Administration drags its feet on filing the paperwork necessary to actually implement these reforms, they are expediting efforts in pursuit of an expansion of the Medicaid program in Cook County.”

The Illinois General Assembly passed and the Governor signed P.A. 96-1501 prohibiting any expansion of Medicaid programs for two years.  The moratorium took effect January 25, 2011.  This week it was learned that Quinn’s Director of Healthcare and Family Services is seeking a waiver to expedite by two years the influx of new Medicaid enrollees in Cook County expected under the new federal Affordable Care Act.  This expansion would unquestionably violate the moratorium and state law.

 “You don’t have to be a budget expert to understand that Illinois’ Medicaid program is growing at a rate that is unsustainable,” Righter added. “The Governor’s budget projections show that by Fiscal Year 2017 the Medicaid backlog will have reached $21 billion. These expansions are jeopardizing the entire program. Reforms are needed to pull this program back from the brink of insolvency, to ensure we still have a safety net for the people who truly need it.” 

Proponents argue this will not cost the state any money.  This is, at the least, a highly debatable point.  If we allow Cook County to add 100,000 people to its Medicaid rolls and the federal ACA is repealed or struck down in the courts, Cook County will turn to the State to make up the lost federal dollars it expected to receive. This could be as much as $125 million annually.

 “The moratorium was the top priority of our major reform bill of 2011, and it would set a bad precedent to ask for a waiver to expand the Medicaid population in this time of fiscal crisis,” said Bellock.  “We will be introducing legislation encouraging prompt enactment of our bi-partisan reforms already passed into law.”