A major insurer is threatening to leave the state’s Medicaid managed care program if Illinois can’t figure out how to pay it — a move that could force 235,000 Illinois residents to get new coverage.

Aetna Better Health of Illinois President Laurie Brubaker said in a court filing last week that the state owes the insurer $698 million.

Brubaker wrote at the time that if the state did not pass a budget by July 1 to stabilize the program and pay Aetna that money “Aetna Better Health may be left with no choice” but to file a notice of its intent to terminate its contracts with the state on or before Dec. 31.

Aetna spokeswoman T.J. Crawford confirmed in an email Thursday that the insurer has filed that notice. She noted, however, that the company still hopes it ultimately won’t have to pull out of the program. State lawmakers passed a budget late Thursday afternoon. Afterward, Crawford declined to comment on whether Aetna would reconsider its position.

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Insurer threatens to pull out of Illinois’ Medicaid program amid budget woes – Chicago Tribune