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A newly revived Pat Quinn?

Wednesday, Feb 15, 2012

* Last week, Gov. Pat Quinn’s administration announced it wasn’t going to wait for federal government approval to implement Medicaid fraud rules. The feds wanted yet another study before agreeing to allow Illinois to check residency and income status before adding people to the Medicaid rolls

[Federal] officials wanted another study of the Illinois proposals, but [Julie Hamos, director of the Illinois Department of Healthcare and Family Services] said she feared that six months from now “we would still be tearing our hair out and saying, ‘Where is the approval?’”

Medicaid is Illinois’ single biggest operating expense, a $14 billion program with 2.7 million people on the rolls. That’s 1 in 5 Illinois residents.

It is a lifeline for many poor people. But there’s good reason to think that many people are getting Medicaid from Illinois who don’t qualify for it — who don’t even live in Illinois. In a letter to federal authorities, Hamos revealed that about 6 percent of Medicaid identification cards sent to Illinois households in November bounced back as “undeliverable with out-of-state addresses.”

* And, now, Quinn is looking to at least temporarily bypass the General Assembly on setting up a new health insurance exchange

Gov. Pat Quinn is weighing whether to use an executive order to jump-start planning for Illinois’ health insurance exchange, a move that could rankle both state legislators and business groups.

In an apparent sign of impatience with the slow-moving Illinois General Assembly, a spokeswoman for the governor said the administration may use the order to create the “skeleton” of an exchange, which would allow staff to push forward with planning efforts.

That option immediately drew criticism.

“We would not favor that approach,” said Laura Minzer, executive director of the Health Care Council of the Illinois Chamber of Commerce. […]

Jim Duffett, executive director of the Champaign-based campaign, called creating the exchange via an order “a very viable thing” that would “move the process forward.”

Duffet has been arguing that business interests have too tightly controlled the legislative process to create the exchange. which is required under the federal health insurance reform law.

* What do you think? Do these actions show that Pat Quinn is acting more like a governor, or is it just my imagination?

* Related. and a Statehouse roundup…

* ADDED: Illinois could divert tax refunds of city debtors

* Cellini’s wife off preservation agency board: Without fanfare, Democratic Gov. Pat Quinn filed a notice with the secretary of state that he was making a new appointment to the spot held by Julie Cellini, whose term had expired.

* Illinois chamber joins lawsuit over ‘Obamacare’

* Business group wants quick decision on health care

* Editorial: Citizens deserve power to enact ethics reforms

* Constitutionality of Illinois eavesdropping law challenged in court - Attorney argues statute ‘not designed to protect police conduct that is open and in public,’ should not prohibit audio recording

* Lawmaker proposes new solution to distracted driving in Illinois

* High-tech car gadgets distracting, experts say

* Another plan floated to ground state’s air fleet

- Posted by Rich Miller        


30 Comments
  1. - Fed up - Wednesday, Feb 15, 12 @ 10:32 am:

    Pat Quinn has been acting like an Illinois Governor, lying to get elected, buying lawmakers votes with future jobs, spending money the state doesn’t have. Yeah he seems to be a typical Illinois governor


  2. - soccermom - Wednesday, Feb 15, 12 @ 10:37 am:

    That’s my PQ! Way to go!


  3. - mark walker - Wednesday, Feb 15, 12 @ 10:38 am:

    We must move on Medicaid or drown, and I’d trust Julie Hamos to move this in the right direction.

    The health insurance exchange, which is an open and free market approach, has been delayed by narrow and shortsighted interests. We should move forward on this as well.

    Quinn is leading here; the GA should catch up rather than complain about prerogatives.


  4. - wordslinger - Wednesday, Feb 15, 12 @ 10:47 am:

    –In a letter to federal authorities, Hamos revealed that about 6 percent of Medicaid identification cards sent to Illinois households in November bounced back as “undeliverable with out-of-state addresses.”–

    There’s no point waiting around to try to trim the ineligible off Medicaid. Good move.


  5. - Don't Worry About the Government - Wednesday, Feb 15, 12 @ 10:51 am:

    One would think that there would be strict administration procedures and fraud prevention in place before they pass these types of public policy that end up costing billions. Instead they just pass bills and let departments deal with the problem, oftentimes after massive fraud and misuse is detected.

    Check this stuff at the door, require people to show proof of residency, make them do it monthly for all I care, if you are recieving a benefit from the state then working a little bit for it is not the end of the world. I don’t really even care if it isn’t cost effective, at least the taxpayer will know that the people receiving the aid is somewhat deserving (I say somewhat because I disagree with a lot of the qualifiers for aid in Illinois).


  6. - siriusly - Wednesday, Feb 15, 12 @ 10:58 am:

    I agree with you Rich. This looks like a bit of leadership. Encouraging to say the least.

    The opinions expressed by Siriusly are subject to change without notice. In the event the old Quinn comes back, Siriusly reserves the right to change stated opinions and call him jello again without notice.


  7. - Robert - Wednesday, Feb 15, 12 @ 11:08 am:

    If Gov. Quinn doesn’t get involved early, the legislative leadership complains he wasn’t involved.

    If Gov. Quinn states an opinion early, the legislative leadership gets mad that he’s getting involved.

    Giving them the benefit of the doubt, perhaps they want him to work more together? Is the real concern that he’s governing by press release rather than engaging them in conversation about the issues?


  8. - Rich Miller - Wednesday, Feb 15, 12 @ 11:16 am:

    ===Is the real concern that he’s governing by press release rather than engaging them in conversation about the issues? ===

    Yes.


  9. - Retired Non-Union Guy - Wednesday, Feb 15, 12 @ 11:27 am:

    Quinn’s at least starting to act like a real Governor. Now he needs to refine his actions by at least backdoor informing the legislative leaders before he issues the press releases. After all, a lot of leaders used the bully pulpit to advance their ideas and plans … but they were politically astute enough to have a bit of at least covert backing before doing so …


  10. - Cassandra - Wednesday, Feb 15, 12 @ 11:33 am:

    How reliable is returned mail as an indicator of fraud. Just being transient doesn’t mean you aren’t qualified for this program. And the USPS doesn’t always get it right. Occasionally, when we have our mail forwarded during a trip somebody tells us their letter came back saying we didn’t live here, our residence of decades. Too many possibilities other than fraud.

    And what will fraud mean when everybody is required to have health insurance in 2014. Can we cut people off because they now live in Iowa but still have an Illinois card. Isn’t that illogical.

    Provider fraud, absolutely. I’m sure it is rampant. Individuals–seems like a boondoggle–is it worth the resources with ACA coming up so quickly.


  11. - Rich Miller - Wednesday, Feb 15, 12 @ 11:36 am:

    ===Individuals–seems like a boondoggle–is it worth the resources with ACA coming up so quickly. ===

    Let’s shave off a full percentage point for your concerns about the postal service. So, five percent of $14 billion is $700 million a year. It may be more, it may be less. Whatever the case, that’s real money.


  12. - state worker - Wednesday, Feb 15, 12 @ 11:52 am:

    Quinn is capable of and willing to listen to problem-solvers when he isn’t bogged down in politics. Hamos is a problem-solver grounded in reality. She is capable of addressing the situation we have, not the one we want, and working out the best solution. Legislators can’t get off their polarized positions to do this. Kudos to both of them for being adults and grappling with an unbelievably bad financial situation that can’t wait.


  13. - John Galt - Wednesday, Feb 15, 12 @ 11:58 am:

    I’ve gotta say I like Sen. Millner’s approach to the distracted driving issue. Rather than creating a laundry list of “thou shalt not’s” while driving that could be abused by some cops, focus on the undesired result: crummy driving.

    It’s fairer to drivers, fairer to industry groups who opposed the other bans (cell phones, fast food, etc.), and it reduces the chance that the occasional bad cop would use it as pretext for pulling somebody over.

    A much more elegant solution. Millner’s a good one and he’ll be missed when he steps down next year.


  14. - Chris - Wednesday, Feb 15, 12 @ 12:16 pm:

    “Let’s shave off a full percentage point for your concerns about the postal service.”

    Heck, cut it in half–$420 million a year is *still* worth the effort.

    I know people (not “know of”, know) who “moved” temporarily to Cook County to avail themselves of Cook County (don’t call it Stroger, or I’ll cut you) Hospital for surgical procedures. Don’t doubt there are people doing similar things across state lines, as it seems Illinois is relatively generous amongst our neighbors.

    And, on the basic question, yes, it seems like PQ is acting like a governor; now, he just need to actually follow through and get one of these things done.


  15. - Anyone Remember? - Wednesday, Feb 15, 12 @ 1:08 pm:

    Wordslinger -

    With all due respect, I have to disagree with you on using USPS. Fraud is fraud, and must be stopped.

    However, Chicago has among the worst USPS service in the country - do a Google search. True story - friend works for a state agency with a (now retired) field based employee who lived in Chicago. Paper paycheck mailed twice a month using computer generated mailing label to the employee’s residence.

    One time, check was late. When it arrived, it had taken 4 attempts by the local PO to get it to an existing address (as they had done before and since with no problems). The third attempt, which failed, was manual. That’s right - a real person, not the computer, said a long standing address did not exist. And had the paycheck envelope said “do not forward” it would have come back to my friend stamped “undeliverable” … .

    That is why I do not accept “inability of USPS to deliver” as proof of anything. Fraud must be stopped, but USPS can’t be relied upon as proof positive of fraud.


  16. - wordslinger - Wednesday, Feb 15, 12 @ 1:17 pm:

    –Wordslinger -

    With all due respect, I have to disagree with you on using USPS. Fraud is fraud, and must be stopped.–

    Wasn’t me.


  17. - Irish - Wednesday, Feb 15, 12 @ 1:40 pm:

    I have been wondering why our GA has been dragging it’s feet on establishing the exchange. It doesn’t look like they are very supportive of the President’s agenda.

    Also, on one hand Hamos is trying to reduce Medicaid participants citing buget concerns. (Which I support, we should not be sending state aid to individuals who don’t live here or who make enough to be ineligible.) But on the other hand she also wants to expand Medicaid coverage for people who live in Cook County, and who agree to go to Stoger hospital for treatment. In essence she is asking for permission to take money from a state that is broke and subsidize another government entity. So are we broke or not?

    We have a governor who doesn’t honor his word and contract to some of his employees while giving others raises. We have a governor who wnats to close state institutions and put special needs people in the southern part of the state out on the street while wanting to subsidize a failing institution in Chicago. We have a governor who recently took money that was promised to Conservation Police for their raises and put it into hiring more conservation police only if they are veterans and waived the two year college requirement for those veterans. We have a governor whose favorite saying is “everybody in no one left out” yet who consistently shows through his actions that he favors some people at the expense of others. It reminds me of the scene in ” Butch Cassidy” where Butch and the Kid are laying on the rock watching the guy in the white hat with a posse that is tracking them and Butch says “Who is that guy?”


  18. - RetiredStateEmployee - Wednesday, Feb 15, 12 @ 2:15 pm:

    One has to wonder whether HFS has the talent left for this kind of process development. As an example, the CIO of HFS has degrees in horticulture and landscape architecture. (Look it up on LinkedIn). This kind of gets into the patronage issue as well. If the governor doesn’t put people in positions like this that are qualified, then I don’t see how the systems at HFS will get improved. I know that the part of the system I worked on in the past has no one there working on it and there are potentially millions of dollars of federal match being missed because of a sloppy (technical term) system. Now that the reputation of government employees and the way they are treated by the Governor is well known, will the state be able to attract the talent to address these problems?


  19. - Anyone Remember? - Wednesday, Feb 15, 12 @ 2:19 pm:

    Wordslinger -

    Was responding to this.

    == –In a letter to federal authorities, Hamos revealed that about 6 percent of Medicaid identification cards sent to Illinois households in November bounced back as “undeliverable with out-of-state addresses.”–

    There’s no point waiting around to try to trim the ineligible off Medicaid. Good move. ==


  20. - Frank - Wednesday, Feb 15, 12 @ 2:19 pm:

    ==The health insurance exchange, which is an open and free market approach==

    New government handouts and new regulations are “free market” now?


  21. - Dale - Wednesday, Feb 15, 12 @ 2:19 pm:

    Leadership would be addressing the budget problems this state faces. Until PQ is serious about actually governing, these are just headline gimmicks.


  22. - Health Care Justice - Wednesday, Feb 15, 12 @ 3:11 pm:

    Rich, one slight mistake - it is not businesses with too much influence - it is the insurance industry. Small Businesses, consumers, and health experts should be on the Marketplace (exchange) board and the fox (insurance industry) guarding the chicken coop


  23. - Retired Non-Union Guy - Wednesday, Feb 15, 12 @ 4:51 pm:

    Irish @ 1:40

    Just checked and as far as I can find with a quick check, the ACA exchange rules have not been finalized … so it might have to do with the fact the rules are still just proposals.


  24. - Pleasantly Surprised - Wednesday, Feb 15, 12 @ 5:22 pm:

    I’ts Brooke Anderson that is helping him look like he’s just as interested in governing as he is in being Governor


  25. - dave - Wednesday, Feb 15, 12 @ 6:53 pm:

    **n essence she is asking for permission to take money from a state that is broke and subsidize another government entity.**

    This is incorrect. The state would spend no extra money with Cook County’s waiver. Zero.


  26. - Judgment Day - Wednesday, Feb 15, 12 @ 7:08 pm:

    “One would think that there would be strict administration procedures and fraud prevention in place before they pass these types of public policy that end up costing billions. Instead they just pass bills and let departments deal with the problem, oftentimes after massive fraud and misuse is detected.

    Check this stuff at the door, require people to show proof of residency, make them do it monthly for all I care, if you are recieving a benefit from the state then working a little bit for it is not the end of the world.”

    If you know how the ‘insides’ are currently operating, and the Systems that Public Aid is dependent on using, well, you would be anything but surprised.

    As for “require people to show proof of residency”, that already happens over and over and over again to virtually anybody in the system. Public Aid is already drowning in paper (some would say “drowned”), and more paper is absolutely meaningless - it actually gets in the way.

    We’ve got to come up with a radically different approach. In fact, I happen to know of a little “skunk works” type project that is being prototyped for Public Aid.

    There’s a very tiny group of low level insiders who are down in the trenches and a coupe of out-of-work/under employed software geeks who are working on an open source PA System (multiple modules; such as Food Stamps [SNAP


  27. - Yellow Dog Democrat - Wednesday, Feb 15, 12 @ 7:33 pm:

    Yes Rich, this is a new and improved Pat Quinn.

    I think it was either Mike Lawrence or Prof. Greenberg who wrote “When the General Assembly is in session, the Speaker is the most powerful man in Illinois.”

    My corollary is “Governors are most powerful when the legislature is not in session.”

    The challenge of course being that the biggest concern of the public right now is the budget, which requires both men to work together.


  28. - Judgment Day - Wednesday, Feb 15, 12 @ 7:37 pm:

    “One would think that there would be strict administration procedures and fraud prevention in place before they pass these types of public policy that end up costing billions. Instead they just pass bills and let departments deal with the problem, oftentimes after massive fraud and misuse is detected.

    Check this stuff at the door, require people to show proof of residency, make them do it monthly for all I care, if you are recieving a benefit from the state then working a little bit for it is not the end of the world.”

    If you know how the ‘insides’ are currently operating, and the Systems that Public Aid is dependent on using, well, you would be anything but surprised. The back office operations are in a state of chaos.

    As for “require people to show proof of residency”, that already happens over and over and over again to virtually anybody in the system. Public Aid is already drowning in paper (some would say “drowned”), and more paper is absolutely meaningless - it actually gets in the way.

    We’ve got to come up with a radically different approach. In fact, I happen to know of a little “skunk works” type project that is being prototyped for Public Aid.

    There’s a very tiny group of low level insiders who are down in the trenches and a couple of out-of-work/under employed software geeks who are working on an open source PA System - multiple modules; such as Food Stamps (SNAP Benefits); Cash; TANF; and Medical (still researching this one); and maybe some other areas.

    This tiny bunch of crazies (we’re just not smart enough to know that we’re trying to do the impossible) is busy creating a WAMP/LAMP based environment for Public Aid to handle/process all the back end paperwork.

    The inside problems at DHS aren’t policy related as much as the back office operations are totally failing under the workload.


  29. - LTSW - Wednesday, Feb 15, 12 @ 8:21 pm:

    You can’t equate 6% of the cards being returned with 6% fraud in the $14 billion dollar program. Not all recipients incur the same costs. 18% of the Medicaid population (the elderly and disabled)incurs 78% of the program’s cost. The new eligibility system required by the ACA will drastically alter how income is calculated and will require matches with other databases. Hope it all works.


  30. - steve schnorf - Wednesday, Feb 15, 12 @ 8:27 pm:

    I’m not sure we can extrapolate that if 6% of notices come back undeliverable tht we can produce 6% savings. Since with the exception of the HMOs (small number) medicaid payments are transaction based, for there to be savings the ineligible person has to not only have a card, they have to be using it.


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