Lawmakers, advocates, opponents hash out reform for Medicaid, workers' comp

[November 30, 2010]  SPRINGFIELD -- Echoes of the long campaign season could be heard Monday at the Capitol, as Senate lawmakers charged with reforming the state's Medicaid and workers' compensation systems heard criticisms of the programs -- often voicing the complaints themselves.

As the state-federal health care program for the poor and disabled, Medicaid currently serves 2.8 million Illinois residents at an annual cost of about $7 billion. The number of participants is expected to swell by 700,000 at an annual cost of $2 million when the federal health care reform law opens up the program to poor single adults in 2014.

State Sen. Dale Righter, R-Mattoon, is concerned that too many Medicaid enrollees stay in the program when their eligibility expires, and he wants to end so-called "passive determination," when participants simply state they are still eligible.

Julie Hamos, a former Democratic lawmaker who heads up the Illinois Department of Healthcare and Family Services, agreed.

"I may be the first director of this agency that has come before you to say we should end it," Hamos said. "So, that's the first step -- is to really make sure that we're all moving in the same direction."

But that's where the two parted ways. Hamos wants to collect data from tax returns and employment records to determine eligibility, while Righter wants a more direct approach.

"Why shouldn't it be the client's responsibility?" Righter said. "Why should it be the client's responsibility to say, 'After 12 months of being on Medicaid, I need to demonstrate once again that I'm still eligible for Medicaid.'"

The answer from Michael Gelder of Gov. Pat Quinn's office: money -- or more accurately, the lack of it. Facing an expected $15 billion budget deficit next year, the state simply doesn't have the manpower to handle the nearly 234,000 individuals re-upping for Medicaid at local Department of Human Services offices each month.

However, the state won't look to trim costs by cutting eligibility to the non-Medicaid part of the All Kids program, Gelder said. Republicans have often harped on lowering parental income levels on the state-subsidized health insurance program for all children.

"That's not something that we, the governor's office, has introduced," Gelder said. "It would depend on what the General Assembly would do with legislation like that. But that hasn't been our recommendation."

So goes Medicaid reform, so far. Senate leaders also have tasked their colleagues with reforming the state's workers' compensation system.

Business leaders have complained for years that the high costs of workers' compensation insurance and settlements have turned potential businesses and their jobs away from Illinois.

Todd Maisch, a lobbyist for the Illinois Chamber, hopes lawmakers finally will take action.

"The legislature has been saying for three years now that jobs is their top priority, and now it's time to demonstrate that," he said.

Maisch said that any meaningful reform would have to tackle issues such as distinguishing between a degenerative physical condition and an on-the-job injury. Additionally, objective physical impairment guidelines must be quantified to more fairly compensate injuries, he said.

No way, according to a labor representative.

"Those are things we're going to fight tooth and nail to protect working people in the state of Illinois," said Sean Stott of the Laborers' International Union of North America.

Michael Carrigan, president of the Illinois AFL-CIO, told lawmakers any reform legislation would have to come through an agreed bill.

"Negotiations in the past have been done through the agreed process, and to me, they've been a product of negotiations," Carrigan said. "Labor and business worked very hard. They brought their items in, and just like classic negotiations, they negotiated. Everybody gave up something in order to come out with a bill at some point."

However, both chambers of the legislature must be on board for any real change. The Senate nearly two weeks ago created the two reform commissions, with a completion due date of Jan. 3. The House has since followed suit, calling for separate meetings on Medicaid and workers' compensation reform on Friday.

"I'd say that we've moved from being fairly skeptical to being cautiously optimistic," said Maisch.

[Illinois Statehouse News; By MARY MASSINGALE]