* WCIA TV…
While Congress is determining the fate of the Affordable Care Act, Governor Bruce Rauner’s administration is quietly preparing a massive overhaul to the state’s Medicaid system.
Up to 3.2 million Medicaid patients in Illinois, including 1.4 million children, could be affected under a new plan set to take place on January 1, 2018. Industry experts expect many of the state’s poorest patients would have to change doctors, while others could be forced to change prescriptions.
Rob Karr of the Illinois Retail Merchants Association says, “I think [Medicaid patients] will see some changes perhaps in who they can go to. Perhaps there will be changes on the margins in terms of what drugs they can use.”
Some in Springfield are preaching caution… Comptroller Susana Mendoza, a Democrat, pointed to the fluidity on Capitol Hill as a prime reason to press pause on this plan. “I think it is important to wait just so that we have a little bit better as to what those estimates for the Medicaid population are going to be,” she told WCIA.
Mendoza testified Wednesday before the House Human Service Committee, urging lawmakers to intervene and block the Rauner administration from making structural changes to consolidate Managed Care Organizations.
* They’re running out of time, however. Crain’s…
With bids due Monday for private insurers who want a piece of a key Illinois Medicaid program, one of the biggest health plans is in talks with potential buyers.
For Chicago-based Family Health Network, known as FHN, the effort to sell off its assets or enrollees to another health plan is a last-ditch effort to keep from suddenly shuttering. After all, there will be losers: Gov. Bruce Rauner’s administration is revamping its Medicaid managed care program. Twelve insurers, including FHN, have to rebid to participate, but in an effort to squeeze out more savings, the state plans to award just up to seven contracts.
The reboot has whipped the health care industry into a frenzy. In April, the FHN board chairman said he feared the state was locking the insurer out of a new contract. Like vendors across the state, the insurer is owed money by the State of Illinois: Among a backlog of state bills that tops $12 billion, FHN’s overdue tab comes to about $260 million.
As for FHN’s discussion with potential buyers about selling off parts, if not all, of its business, “Essentially at some point that’s what they’re being forced to do,” Illinois Sen. Omar Aquino says. Aquino’s legislative district includes two of the five hospitals or health systems that co-own the insurer. “They would rather prefer to stay in business.”
Aquino is among five Democratic sponsors of a resolution that seeks to suspend the bidding process and highlights the plight of FHN in particular. A spokeswoman for the health plan declined to comment.
* From the JB Pritzker campaign…
In response to Bruce Rauner’s attack on Medicaid, which could strip over 3 million Illinoisans, including over 1 million children, of their right to keep their doctors and prescriptions, JB Pritzker released the following statement:
“While Donald Trump and Republicans in Congress work to gut the Affordable Care Act, Bruce Rauner is working to upend Medicaid coverage for millions of low-income Illinoisans,” said JB Pritzker. “Over 3 million Illinoisans, including over one million children, could be forced to change doctors and even prescriptions if Rauner is able to shove through this overhaul. Illinois families have a right to quality and affordable health care and we need a Governor who will stand up to Donald Trump to protect that right. Instead, Bruce Rauner’s failed leadership has left us without a plan to combat Trumpcare and without a balanced budget as Illinois families continue to pay the price.”