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*** UPDATED x2 - Mendoza responds *** Illinois ordered to pay its Medicaid bills

Friday, Jun 30, 2017

* Judge Joan Lefkow just lowered the boom…


Half of that $586 million is reimbursed by the federal government, but it’s money the state doesn’t have and won’t have without a budget.

*** UPDATE 1 ***  From Comptroller Susana Mendoza…

As if the Governor and legislators needed any more reason to compromise and settle on a comprehensive budget plan immediately, Friday’s ruling by the U.S. District Court takes the state’s finances from horrific to catastrophic. Payments to the state’s pension funds; state payroll including legislator pay; General State Aid to schools and payments to local governments – in some combination – will likely have to be cut. Payments to the state’s bond-holders will continue uninterrupted. A comprehensive budget plan must be passed immediately.

*** UPDATE 2 *** The order is here.

From a press release…

In the face of the State of Illinois’s ongoing budget impasse, a federal court today ordered the state to substantially increase monthly outlays to pay bills for healthcare provided under the Medicaid program. Under the court’s order, if the budget impasse continues, the state Comptroller is obliged to pay $586 million toward the state’s Medicaid obligations monthly, as opposed to the current payments of about $160 million. The state will be able to claim reimbursement for half of those expenditures from the federal government.

The court-ordered payment, which is the amount the state ordinarily pays in years when there is a budget in place, will prevent the $4 billion backlog of unpaid bills from growing larger. The court also ordered the state to pay $2 billion toward the backlog of unpaid bills over the next 12 months, with the goal of getting it down to the amount owed before the state budget impasse started.

In issuing the order, Judge Lefkow additionally emphasized that the State shall, “prioritize appropriate preference to ‘Safety Net Hospitals’ and other providers most crucial to affording the plaintiff class members’ access to federally mandated healthcare services.”

“The court’s order prevents the collapse of the healthcare system that serves children, families, seniors and people with disabilities across Illinois,” said David Chizewer, an attorney with the Chicago law firm Goldberg, Kohn, who is part of the team representing the healthcare beneficiaries. They are also represented by attorneys from the Sargent Shriver National Center on Poverty Law (Shriver Center) and Legal Council for Health Justice.

Although the court had previously ordered the state to make Medicaid payments during the budget impasse, for two years it has been paying only a small percentage of those bills. The growing backlog of unpaid bills precipitated the current crisis. “Without these payments, doctors, hospitals, clinics and other key healthcare providers would stop seeing Medicaid patients, or else simply go out of business altogether,” said Tom Yates, of Legal Council for Health Justice.

“It is important to note that the Illinois General Assembly met today, the last day of the fiscal year, to try finally to pass a full year fully funded budget,” said the Shriver Center’s John Bouman. “We urge them to get that work done and to be sure it includes a path to pay down the back bills. That is the only sure way through this thicket.”

- Posted by Rich Miller        

56 Comments
  1. - Saluki - Friday, Jun 30, 17 @ 6:00 pm:

    Oh oh.


  2. - Ihatepolitics - Friday, Jun 30, 17 @ 6:02 pm:

    That’s gonna leave a mark


  3. - No Raise - Friday, Jun 30, 17 @ 6:08 pm:

    That’s fine, but employee health insurance claims should be paid as well. Right now, some claims are still owed from 2015. Not exactly sure of the specifics of this ruling, and I understand there are federal matching funds, but under no circumstances should an employee or retiree, paying monthly premiums, have their claims paid at a slower pace or over a longer period of time than any other health claims.


  4. - Ron - Friday, Jun 30, 17 @ 6:10 pm:

    There’s no money. Can’t pay if you don’t have it.


  5. - JoeMaddon - Friday, Jun 30, 17 @ 6:13 pm:

    Raise — state employee health insurance are not covered by federal laws (as Medicaid is) and therefore are not subject to federal consent decrees and court orders in the same way.

    This isn’t some random judge ruling to pay random bills. This is a federal judge ruling that because Medicaid is an entitlement and covered by federal laws, consent decrees, and court orders, therefore the State has to pay its Medicaid bills.


  6. - Abu Iskandr - Friday, Jun 30, 17 @ 6:15 pm:

    My understanding is that we have a budget–we just do not have the revenues to pay for it. And, if I understand the Comptroller, the till runs dry in August, leaving school districts in the position of needing to sue, to try to leapfrog other groups.

    Not a great way to run a railroad.


  7. - Ole' Nelson - Friday, Jun 30, 17 @ 6:16 pm:

    I am starting to doubt the Governor’s claim that the 5% income tax wasn’t necessary and that he could balance the budget by cutting waste, etc. /s


  8. - Lucky Pierre - Friday, Jun 30, 17 @ 6:19 pm:

    Given that there is no money to pay these Medicaid or state health insurance bills on time, why did the Democrats vote to expand taxpayer funded abortion?

    Only 4 states currently pay for this voluntarily, but Illinois Democrats were eager to push their out of touch agenda.

    There is no Federal match and this would cost Illinois taxpayers an additional 60 million dollars a year.

    More divisive politics from Speaker Madigan instead of responsible governance.


  9. - Patrick Staarr - Friday, Jun 30, 17 @ 6:21 pm:

    Could this be the straw? The GA best get to it tomorrow and do what needs to be done. A revolt needs to happen and everyone must be on board, take the hits and do what is good for the state, not for their own interests.


  10. - Chicago Cynic - Friday, Jun 30, 17 @ 6:25 pm:

    Ruh Roh.


  11. - Ginhouse Tommy - Friday, Jun 30, 17 @ 6:25 pm:

    I am legally challenged here. Can the Governor and Legislators be held in contempt for no following the judges order? The only way to shake up Rauner is to go after him personally. It was just a thought.


  12. - JS Mill - Friday, Jun 30, 17 @ 6:27 pm:

    Oh Lucky, there you go again!

    If only your failed governor knew how or had the courage to propose a balanced budget when he took office two and a half years ago!

    Abortion has nothing tow do with this issue. But troll away, that is all you have.

    Medicaid expansion was extremely beneficial to a large number of GOP voters outside of Cook County. Rural Illinois is prime GOP territory and benefits.

    But you can dream that you are not really a hypocrite.


  13. - Norseman - Friday, Jun 30, 17 @ 6:30 pm:

    === That’s gonna leave a mark ===

    Spit-take

    Yep. Let’s hope this does push the ball over the line.


  14. - Wensicia - Friday, Jun 30, 17 @ 6:43 pm:

    I can’t wait to read the Tribune editorial response to this ruling.


  15. - Skirmisher - Friday, Jun 30, 17 @ 6:44 pm:

    Any rational person knows that with this ruling the game is definitely up. Yet I suspect there are many under the dome still incapable of accepting that reality. I am still not optimistic.


  16. - Sue - Friday, Jun 30, 17 @ 6:47 pm:

    For anyone who has appeared before J Lefkow you know she is as liberal and politically tone death as they come. She will be reversed at some point. Federalism means something and it means the Feds cannot dictate how a Stste prioritizes its payments absent a prior finding of discrimination or constitutional violations. Joan Lefkow is as leftist as they come. The State needs to file an emergency appeal immediately after it has a budget


  17. - DuPage Saint - Friday, Jun 30, 17 @ 6:52 pm:

    GOOD. Bite the bullet and get it done or go home and let the feds take over. Great job Rauner. Great job Madigan.
    And to the rest of the general assembly: go out and buy Bob Dylan and play “Only A Pawn In Their Game” repeatedly. Excuse grammar I am ticked


  18. - Norseman - Friday, Jun 30, 17 @ 6:56 pm:

    Sue, I can’t wait to see an appellant brief from Rauner saying that this liberal judge is preventing him from extending his impasse to force Dems to cave in to his agenda. LOL 😂


  19. - Lucky Pierre - Friday, Jun 30, 17 @ 6:56 pm:

    Expanding health care access to cover abortion at the cost of 60 million dollars a year when you can’t pay your current bills has everything to do with the issue at hand, JS Mill

    How do you think we got to this point in the first place?

    By increasing government spending to accommodate special interest groups.


  20. - No Raise - Friday, Jun 30, 17 @ 6:56 pm:

    It’s time to consider a federal suit against the State under the U.S. Constitution’s Contract Clause. State violating it’s contracts with providers under state contract law as well as violating fundamental contract principles to employees and retirees opting for health insurance whereby premiums paid but state does not budget the money to pay providers. See how Lefkow rules on that.


  21. - Rich Miller - Friday, Jun 30, 17 @ 6:57 pm:

    === the Feds cannot dictate how a Stste prioritizes its payments absent a prior finding of discrimination or constitutional violations===

    This is a consent decree. The state consented to it. She gets to decide if the state is in violation or not.


  22. - illini - Friday, Jun 30, 17 @ 6:58 pm:

    — A comprehensive budget plan must be passed immediately. —

    So is tomorrow going to be the day, or will this be yet more of a protracted debate that will continue into next week? And if we do get a budget with the with the required revenue, how many Republicans will vote to approve? And the big question is will Gov. Rauner sign it.

    Too many questions and no certain answers.

    Time to restock the liquor cabinet!


  23. - Oswego Willy - Friday, Jun 30, 17 @ 7:02 pm:

    - Lucky Pierre -

    You need to come to grips with the HB40 reality that Rauner, well, Diana and Bruce, have to choose if the questionnaire is real or just as phony as Rauner is in costume.

    To the Post aspect,

    This ruling… to be clear… pushes today’s success to the side, but also its a foundation to that new level. This budget nonsense can’t be put off. It never should have been put off, but we need to realize as a state, the politics needs to back away from the required governing even a federal judge sees as lacking.


  24. - RNUG - Friday, Jun 30, 17 @ 7:09 pm:

    Nit hard to predict pension funding and, maybe, general school aid is where they will find the cash.


  25. - Hawkeye - Friday, Jun 30, 17 @ 7:13 pm:

    Q: What’s worse than FUBAR??

    A: Illinois


  26. - btowntruth from forgottonia - Friday, Jun 30, 17 @ 7:14 pm:

    Remember all the “popping the nuke” talk?
    Lefkow might have just pushed Madigan and that victim of a governor of ours aside and popped it for them.


  27. - Sue - Friday, Jun 30, 17 @ 7:14 pm:

    Based on Rich’s post- I retract. Why the State entered a consent decree is a bafflement. They could have filed a motion to dismiss claiming sovereign immunity and moved the dispute to the act of claims. Who is giving the Governor legal advice during this morass?


  28. - jw - Friday, Jun 30, 17 @ 7:21 pm:

    Lucky Pierre did you miss school the days they passed out brains and compassion for your fellow man?


  29. - dd - Friday, Jun 30, 17 @ 7:35 pm:

    Next up a Receiver and Special Master together with a full audit. She has the independence and courage to move it forward.


  30. - RNUG - Friday, Jun 30, 17 @ 7:43 pm:

    == Next up a Receiver and Special Master together with a full audit. She has the independence and courage to move it forward. ==

    Not necessarily. I don’t know if it is still current practice, but the Feds routinely audited not only the receiving agency, but also third party receipiants like CMS that indirectly received money for services to the agency.


  31. - RNUG - Friday, Jun 30, 17 @ 7:47 pm:

    == They could have filed a motion to dismiss claiming sovereign immunity and moved the dispute to the act of claims. ==

    Federal money comes with Federal strings. Don’t think they could get it dismissed on that claim.


  32. - dd - Friday, Jun 30, 17 @ 7:56 pm:

    Oh my perhaps you do not grasp her enormous power to enforce a decree. Whether she chooses to enforce it is in her discretion but this is someone who knows all the risks. This is 100% the power under the decree.


  33. - dd - Friday, Jun 30, 17 @ 8:04 pm:

    Sorry that was a bit pedantic. Just saying she knows her vast powers and understands the enormous risks but has the independence to move things forward.


  34. - Sue - Friday, Jun 30, 17 @ 8:15 pm:

    Seems from the post that the Order was to be enforced during pendency of impasse. Without reading the Order it’s impossible to say but maybe Lefkow goes away if the budget is passed?


  35. - CCP Hostage - Friday, Jun 30, 17 @ 8:17 pm:

    Free at last


  36. - Blue dog dem - Friday, Jun 30, 17 @ 8:20 pm:

    Lets expand medicaid.


  37. - wordslinger - Friday, Jun 30, 17 @ 8:25 pm:

    For crying out loud, what state does Rauner think he’s governing?

    Catatonia?

    Wake up, step up, Boss. The Most Excellent Frat Boy Party is over (you’re too old for that nonsense, anyway).

    The judge just repoed the pot to p— in.

    You paid $100M of your own dough for this gig, now let’s see those mad leadership skills.

    Because this stuff is real, and you’re the governor, making your mark in the history books.

    Are you trying to make Brownback and Christie look good? Because you are.


  38. - rivvedup - Friday, Jun 30, 17 @ 8:29 pm:

    A state is not sued; rather the State employees (such as the Director of DHS, Comptroller, etc.) are, avoiding the 11th Amendment issue. Court of Claims lacks legal power to enforce Federal law (Medicaid falls under the Federal Social Security Act and implementing Fed regs.). Payments are required under the Act, which requires the State to comply with payment provisions.


  39. - drew - Friday, Jun 30, 17 @ 8:55 pm:

    Maybe this is a bit snarky of me, but perhaps we’re quite fortunate there’s no k-12 education appropriation bill yet enacted for FY18. Without those obligations, I’ve got to imagine we have enough cash in the bank to comply with this order.


  40. - RNUG - Friday, Jun 30, 17 @ 9:22 pm:

    == Without those obligations, I’ve got to imagine we have enough cash in the bank to comply with this order. ==

    Maybe not. Even before this, the Comptroller was predicting coming up short in August. Not as much tax revenue coming in during the summer. And if they don’t solve the multi-state lottery issue, there will be even less.


  41. - DuPage - Friday, Jun 30, 17 @ 9:27 pm:

    Rauner said he was in trench warfare and winning. This ruling is like a napalm air strike direct hit on his trench.


  42. - Big Hurt - Friday, Jun 30, 17 @ 9:44 pm:

    Aw, Lucky, so sweet of you to be concerned about THAT $60 million but frankly it is hard to take you seriously. Especially given your trolling here.

    But seriously, what about he hundreds of millions Rauner costs taxpayers due to interest payments on the additional $10 or $12 billion in backlog of bills we have accrued since he became governor?

    Not so much, huh?

    What about the hundreds of millions all of that schools and local governments have to pay when issuing bonds because of all of the additional Rauner credit downgrades?

    Not a big deal to you?

    But healthcare, that one you just cannot stomach?

    Says all we need to know about you.

    Back under your rock.


  43. - anon - Friday, Jun 30, 17 @ 10:03 pm:

    It appears the judge ruled on the merits but how does she force a state to make payments when they have no resolution to appro funds


  44. - Honeybear - Friday, Jun 30, 17 @ 10:06 pm:

    Had a young man come in for a jobs program DHS is running. Smart young man. But I notice he was wearing kid glasses. Even with those he had to get 6 inches away from the screen to fill out his app. May God bless him. He probably hadn’t had new glasses since he was six. Now he’s in his mid twenties. This is who we are helping folks. He’s doing his best. Don’t begrudge him the help he needs. He’s got next to nothing.


  45. - James - Friday, Jun 30, 17 @ 10:13 pm:

    Excellent work by the plaintiffs’ legal team!


  46. - Union Man - Friday, Jun 30, 17 @ 10:27 pm:

    Now if that judge will rule honestly that State employees cannot be paid without an appropriation, this whole thing might comes crashing down and Rauner will be revealed to be irresponsible. Hooray for the new dawn? I can only hope.


  47. - CCP Hostage - Friday, Jun 30, 17 @ 10:34 pm:

    Many thanks to Stephanie, Tom, and David


  48. - VanillaMan - Friday, Jun 30, 17 @ 10:42 pm:

    Like anything else in life, if you fail to honor your responsibilities, someone else steps in to do the job. There are few vaccums in government. Rauner won’t govern, so someone else will.

    ILGOP can’t complain. They exposed themselves as gullible tools itching to gain power under a rich false leader who is out for revenge, not governing.


  49. - justacitizen - Friday, Jun 30, 17 @ 11:18 pm:

    I still wish the Comptroller was required to be a CPA and the auditor general a CPA/CIA so their credibility was not as questionable. It seems that many still don’t believe the financial/budget numbers and how had they actually are.


  50. - Chucktownian - Saturday, Jul 1, 17 @ 12:16 am:

    That’s it. For goodness sake do you jobs and pass a budget. Now. You can use the Federal court as an excuse but do it. NOW.


  51. - Paceman - Saturday, Jul 1, 17 @ 8:58 am:

    Game, set , match, now get to work and “Do your Jobs.”


  52. - Solution - Saturday, Jul 1, 17 @ 9:40 am:

    When a child cannot treat its things properly, those things should be taken away from the child. The Plaintiffs should petition the Court to Order The State to sell assets to satisfy the debts.


  53. - DeseDemDose - Saturday, Jul 1, 17 @ 10:12 am:

    Honey Bear, Thank You for reminding us that social services aren’t just about a budget.


  54. - Leatherneck - Saturday, Jul 1, 17 @ 11:26 am:

    Anyone heard when the appellate court in Mt. Vernon will make a decision on the state employee payroll case? I am convinced that payroll and pensions will probably be the first things skipped/delayed by the Comptroller in order to find the cash (rather than general state aid for schools). Assuming we don’t end up with a budget deal soon.

    I’m also surprised that, unless I missed it, that AFSCME hasn’t weighed in on Judge Lefkow’s order yet.


  55. - RNUG - Saturday, Jul 1, 17 @ 2:52 pm:

    == I am convinced that payroll and pensions will probably be the first things skipped/delayed by the Comptroller ==

    Pensions; they did it last year when they were short of cash.

    Don’t think they will delay payroll; run the risk of running afoul of one or more court orders where federal money is involved. More likely to short more vendors payments.


  56. - Garanimal - Monday, Jul 17, 17 @ 12:18 pm:

    Good point.


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