 At least one lawmaker sees some possible cuts coming, as the state
faces a budget gap of at least $13 billion."I do expect that
revenues (will be) discussed ... , but with the amount of dollars
that are out there, it's going to be impossible to do things
painlessly," said Rep. Frank Mautino, D-Spring Valley.
Mautino's comments came during a daylong Illinois House of
Representatives hearing on changes to Medicaid, a joint
state-federal health insurance program that serves the poor and
disabled. The program targets mostly pregnant women and children
younger than 6 whose families make less than 133 percent of the
federal poverty level, but children up to 18 are also covered if the
family income is less than the FPL. Illinois, however, has expanded
the program to higher income levels.
In Illinois, roughly 2.8 million people benefit from Medicaid.
Mautino said the June 30 end of federal stimulus dollars that
have shored up the system for the past two years will only
exacerbate the problem, likely forcing the state to seek a
combination of increasing revenue and cutting some services.
Topics ranging from tightening the system that checks out
people's eligibility to increasing the amount people in the system
pay for prescription medications were brought up during the meeting
as possible cost-saving solutions.
One area some committee members were concerned about was the
practice of the state paying for health insurance for more than
50,000 undocumented immigrant children. Unlike other sections of the
state-funded children's health care program, the care for
undocumented children doesn't receive any federal match. All of the
funds must come from the state's general revenue fund, according to
Julie Hamos, director of the Department of Healthcare and Family
Services and a former Democratic state legislator.
"We see the issue of serving undocumented (immigrant) children as
a policy issue, one that we're proud of and one this governor
supports, so we are not proposing changes in reducing eligibility
for undocumented children," Hamos said.
However, advocates have noted that health care for children is
relatively inexpensive when compared with adult needs.
Another point of discussion focused on how the state verifies a
family's income, and therefore the family's eligibility for certain
programs. One pay stub annually is all a family needs to provide
right now to show annual income.
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State Rep. Patti Bellock, R-Westmont, who co-chairs the
committee, has introduced legislation that would change that
requirement to proof of a month's worth of income. This provides a
better sense of what a family makes over the course of a year,
proponents claim.
Not everyone wants to see these changes, however. State Rep. Mary
Flowers, D-Chicago, said it's a waste of state resources to chase
after people whose income is likely constantly in flux.
"Income varies from week to week, or it could be from day to day.
... You're really complicating the situation, making it a lot worse,
and you're clogging up the system, chasing after the cheats as
opposed to providing the services which you are supposed to be
providing," Flowers said.
Making any changes that might bump people out of Medicaid could
be tricky. A clause in the federal health care overhaul act says
that states can't make "eligibility standards, methodologies or
procedures" more restrictive than what was in place as of March 23,
2010, without federal approval.
"We don't know really how the federal government will react.
We've told you that we'll make the best case for why income
verification is different from changes in eligibility, but we don't
know how they will react," Hamos said.
The committee is meeting again Tuesday afternoon and will talk
with representatives from the Department of Human Services and the
Illinois Auditor General's office about a recent report on the
state's children's insurance program.
A final report is slated to be finished by Jan. 3, when the
General Assembly returns to Springfield for its lame-duck session.
[Illinois
Statehouse News; By ANDREW THOMASON]
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