* Gov. Pat Quinn said this week that Medicaid has to be cut by $2.7 billion. According to the AP, Quinn’s administration has prepared a “menu” of doable Medicaid cuts totaling $1.9 billion, plus options for reducing provider payments by as much as 9 percent, which would save $825 million…

The list includes some items that probably seem reasonable to people covered by private insurance plans: Limiting the number of eyeglasses paid for each year, for example, or eliminating coverage of chiropractors. The current Medicaid program has no annual limit on eyeglasses or chiropractors.

The menu includes limiting — or eliminating entirely — dental care for adults and “durable medical goods” such as walkers and wheelchairs. It includes axing smaller programs for sexual assault victims, people with hemophilia and refugees who’ve been victims of torture. Obesity surgery is on the list for limits or elimination. […]

The list also include more drastic cuts, such as changing eligibility rules for nursing homes and at-home help so that some incontinent elderly people who can’t prepare their own meals would be denied state-financed care… Also on the menu is excluding illegal immigrant children from the All Kids program. […]

The list states that a 9 percent reduction in payments to hospitals, doctors and pharmacies would reduce state and federal Medicaid spending by $825 million next year. A 6 percent rate cut would reduce spending by $550 million, according to the list.

* Chief Financial Officer Dave Storm of St. Anthony’s Memorial Hospital in Effingham lays out his case…

(I)f Medicaid is looked at historically, it’s not necessarily the costs that are major factors in funding, but the number of patients eligible for Medicaid, Storm said.

As the state increases eligibility for everything from Medicaid to education programs, more people are taking part in the assistance. However, funding hasn’t followed the furnishings.

“But they haven’t done anything to allocate more dollars for those programs. It’s the growth enrollment side of it,” Storm said, adding the cuts go deeper for St. Anthony’s than just losing a portion of Medicaid payments.

The hospital, as well as others in the state, already pay into the hospital assessment program, totaling about $900 million a year from those in Illinois that contribute. Approximately $770 million, is federally reimbursed through Medicaid.

* Another provider speaks…

Dr. Paul DeHaan of Crystal Lake, an orthopedic surgeon with Mercy Health System in McHenry, said Medicaid already is in crisis, and that Quinn’s plan will make things worse.

“Access for Medicaid patients to get in to see a doctor is limited,” DeHaan said. “There are only a small number of practices that will accept new Medicaid patients. Too many doctors won’t or can’t see new Medicaid patients.”

“Private practices are small businesses, just like any small business,” DeHaan added. “They’re strangling under the financial burden of the Medicaid system as it already exists.”

DeHaan, who was in private practice in McHenry for 20 years before joining Mercy Health System six years ago, said Medicaid payments are less than the cost of providing services.

And health-care providers are paid “very, very late. It creates a cash-flow problem for doctors. They cannot make a profit.”

* And another…

Patricia Comstock, executive director of the Springfield-based Health Care Council of Illinois, a group representing long-term care facilities, said reimbursement rates for Medicaid nursing home patients were $120 per day for 24-hour care.

“The funding the state of Illinois provides for our residents is already last in the nation,” she said. “It is impossible for us to think of doing what we are required to do with anything less.”

The providers are well-organized, well-funded and well-represented in Springfield. They’re also right that Illinois has kept reimbursement rates relatively low. Medicaid recipients have no high-powered lobbyists, aren’t all that organized and aren’t well-funded. In some ways, their interests coincide with the providers. In others, not so much.