Saturday, April 16, 2011
 
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New audit, old problems with All Kids Expanded program

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[April 16, 2011]  SPRINGFIELD -- Illinois' Medicaid reform is less than 4 months old, but a new report shows the new get-tough focus of the reforms may have come a little too late.

Illinois Auditor General Bill Holland released a report on Thursday that slams the state's All Kids Expanded program.

The report finds 14 areas of concern about the All Kids program. Illinois had always had a Medicaid insurance program for children whose families earned near the federal poverty level. But former Gov. Rod Blagojevich in 2006 expanded it to cover children whose families made 200 times the federal level, all undocumented children and all uninsured children, despite their parents' income -- hence, the name All Kids.

For the state-subsidized insurance, which is referred to as the All Kids Expanded program, the uninsured children group pays premiums based on income. The new Medicaid reform package passed in January, however, is limiting access to the program to children whose families earn up to 300 percent of the federal poverty level -- or $66,150 for a family of four.

The audit of the All Kids Expanded program focused on 2010 and said the Department of Healthcare and Family Services did not properly manage the program and likely lost out on millions of dollars.

During fiscal 2010, 94,628 children were enrolled in All Kids Expanded. The state does not provide guidance as to how many of those children are undocumented. But the audit says that because many of the children who were added to All Kids are undocumented, they are not eligible for federal reimbursement. The state had to pay $74.4 million for All Kids Expanded, after receiving $9.8 million in premiums from parents.

But Illinois should not have had to pay that much, according to state Rep. Patti Bellock, R-Westmont. Bellock is quick to point out that the audit found that some documented children were misidentified as undocumented. Bellock said Illinois missed out on an enhanced federal match from Washington, D.C., and instead got nothing.

"This program is extremely important, and we want to take care of the children that need the coverage," Bellock said. "But we also want to find out who shouldn't be on that program, or find out who should be on the program but should be getting federal match."

But missed federal money is not the only loss found in the audit. The report found that HFS did not end benefits for many families who did not pay their premiums. Neither Holland's office nor HFS provided a price tag for that oversight.

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Officials with HFS did not respond to many of the specific questions raised by the audit. HFS did respond with a statement, saying it knows about the problems and is working to fix them.

"The Department appreciates the work performed by the Auditor General's Office. We have already taken a number of steps to address the findings in the audit and enhance the integrity of the eligibility process," HFS said in the statement.

Bellock said lawmakers are looking to cut $1.3 billion from Illinois' budget for health care and human services. A report like this may have lawmakers looking at the All Kids Expanded program as a target.

"Nobody wants to cut children away from health care," Bellock said. "So what we would like to do is at least document the people that need to be documented so we can receive the federal Medicaid match. And there is absolutely no reason why that wasn't done."

The audit also rehashes many reoccurring complaints about the program, such as lax reporting of family income and making payments for care that is beyond the scope of the program.

[Illinois Statehouse News; By BENJAMIN YOUNT]

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