* The Republican leaders held a press conference yesterday to express their frustration with the pace of Medicaid reform…
Some Republican members of the Illinois General Assembly accused Gov. Pat Quinn’s administration Monday of dragging its feet on making cost-saving changes to the state’s Medicaid program.
In particular, they said the administration has been slow to begin reviewing Medicaid rolls to eliminate people who do not qualify for benefits.
“To date, they have not even started the process,” said House Republican Leader Tom Cross of Oswego. “We’re now told it won’t be until January of next year that they will start the implementation of ‘scrubbing.’ To put this off until January is unacceptable.”
Well, actually, they have started the process. The law requires the state to award a contract to scrub the Medicaid rolls within the budget year’s first 90 days. The state did it in a little over 70 days. The contractor, Maximus, Inc., will need some time to set up the system to get the work done right.
* The Republicans suggested a political motive…
Cross even suggested Quinn’s delays could be political, putting off the cuts until after the Nov. 6 election. Quinn’s office sharply denied that idea.
“What else could be the reason?” Cross said.
The Quinn administration could’ve waited another three weeks until the 90-day time limit expired to sign the contract, so I’m not sure there’s a huge political conspiracy here.
* Even so, the Republicans are not satisfied…
Maximus will review pay stubs, addresses and other information for current recipients and for people who are signing up for benefits to make sure they live in Illinois and don’t exceed income limits.
It’s not clear how many people will be kicked off the Medicaid roles, but lawmakers and the governor say the change could save $350 million.
Republicans, who have made combating Medicaid fraud a key component in their party platform, complained Monday that the administration isn’t moving fast enough.
They said Maximus should not wait until January to implement the program.
“To put this off until January of 2013 is unacceptable,” said House Minority Leader Tom Cross, R-Oswego.
Republicans say the delay could result in the state not saving as much as money as predicted, which could force lawmakers to have to return to Springfield to make further cuts to the budget.
“There’s no excuse. This was passed last spring,” said Senate Minority Leader Christine Radogno, R-Lemont. “This is something that is not difficult to do.”
Again, the administration signed a contract in a little over 70 days, when the law that the Republicans helped negotiate allowed for 90 days.
And the company has to open a call center, hire workers, let out subcontracts and train state employees to use the new system. That takes time.
The Republicans do make a very valid point, however, that the longer this takes to implement, the fewer savings will be realized by the end of the fiscal year, unless Maximus really kicks it into high gear.
* But GOP claims about the amount of money that could be saved by tightening up the roles have always been a bit on the bloated side…
“There is some research that shows people don’t [game] the system as much as is implied by some. Some of the legislators claimed 20 percent of people are income-ineligible because we haven’t verified their income. I think that is a very high number and not likely,” says Robert Kaestner, a professor at the University of Illinois Chicago who is affiliated with the University of Illinois’ Institute of Government and Public Affairs.
* The company does get results. For instance…
Our Illinois early intervention project produced a $24.5 million net increase in child support collections in the three years through June 30, 2011 – $25.63 collected for each dollar spent
* But there are concerns about outsourcing this sort of work…
Another troubling aspect to this company is that the increase of poverty and pressures to downsize government actually makes for good business. They say as much in their SEC report: “Our core health and human services business has benefited from steady demand over the last five years. We have not experienced any material adverse change in demand as a result of government budgetary pressures. We believe the critical nature of our services in helping governments provide and administer important safety net programs in the U.S., such as Medicaid, welfare-to-work and CHIP, to the most vulnerable populations helps insulate our services from significant downward pressure, particularly during an economic downturn.”
Recently the Project on Government Oversight released a report concluding that the federal government actually pays billions more to hire private contractors than what it would pay current public sector workers to perform comparable work; a Heritage Foundation reports states the opposite. Analyses supporting both sides of this debate are plentiful, but there is little disagreement that over the past several decades, privatization of government services has increased dramatically and hundreds of billions of dollars are spent outsourcing public services.
* The state, however, was clearly in over its collective head on this task…
For more than a year, Republicans have charged that the Quinn administration has not pushed hard enough to implement money-saving reforms targeting ineligible Medicaid recipients. The administration has contended that one attempt to require more paperwork from recipients to prove their eligibility and fight fraud was blocked by the Obama administration because states were not supposed to increase requirements under the president’s signature health care program, the Affordable Care Act.
The state pressed ahead by using electronic methods of matching data, such as with addresses from the Illinois secretary of state’s office, that the federal government deemed more acceptable. Yet the agency said it needed more sophisticated tracking help, leading to the Maximus contract.
* Also, just as an FYI, a longtime member of the Maximus board of directors is former GOP Gov. Jim Thompson.