Tobias Wall, State Capitol Bureau
Wednesday, Nov 26, 2014
Quincy, IL News - QuincyJournal.com
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6 months, 2 weeks ago Tobias Wall, State Capitol Bureau

Republican state lawmakers slammed Gov. Pat Quinn and other Democrats, claiming they've dismantled Medicaid reform

From Tobias Wall, State Capitol Bureau :
Republican state lawmakers slammed Gov. Pat Quinn and their Democratic colleagues Thursday, claiming they've systematically dismantled Medicaid reforms that both sides previously agreed were necessary.
Republican Sen. Dale Righter of Mattoon and Rep. Patti Bellock of Downers Grove announced legislation that would halt any Medicaid expansion efforts until reform goals set in 2011 and 2012 are met and the state's finances are more stable.
Legislation passed in 2011 with bipartisan support required that 50 percent of Medicaid beneficiaries enroll in managed-care programs by the beginning of 2015. Those programs are praised for their cost-effectiveness as enrollees receive care from a network of doctors and hospitals paid at a negotiated rate rather than getting more expensive care on their own.
Just 7 percent of Medicaid enrollees were part of a managed-care program in 2011. But now, with just seven months to go before the end of the year, still only 16 percent of enrollees are in the programs, well short of the statutory goal.
“The goal of 50 percent of all Medicaid enrollees being in a managed-care program by the end of this year was put forth and hailed by the governor and by the Democrat leaders as a reform that would save this state hundreds of millions of dollars down the road,” Righter said.
But he said the abysmal numbers so close to the deadline mean Democrats “have, if not given up on that reform in word, have given up on that reform in action.”
Another grievance Righter expressed was that Democrats stood idly by while an employee union sued to stop the scrubbing of Medicaid rolls even though the process appeared to be tremendously successful.
“That was the cornerstone of the SMART Act,” Righter said, referring to another bipartisan Medicaid reform package passed in 2012. “To make sure that only people who meet the criteria to be on the program and really need the assistance are the people actually on the program.”
Righter said that in the first few months after implementation, the program “was a stunning success” that “even exceeded our expectations as far as rooting out the fraud and abuse in the system.”
He claimed that after reviewing only a quarter of the total number of Medicaid cases, the state stood to save $86 million.

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