Capitol - Your Illinois News Radar » *** UPDATED x1 *** It’s just a bill
SUBSCRIBE to Capitol Fax      Advertise Here      Mobile Version     Exclusive Subscriber Content     Updated Posts    Contact
To subscribe to Capitol Fax, click here.
*** UPDATED x1 *** It’s just a bill

Thursday, Dec 10, 2020

* Press release…

In response to decreased use of health care services through Medicaid managed care organizations throughout the COVID-19 pandemic, state Senate Assistant Majority Leader Dave Koehler, D-Peoria, and state House Assistant Majority Leader Fred Crespo, D-Hoffman Estates, filed legislation today to require companies to return excess profits and reallocate funding to critical health care services.

“While insurance companies and managed care organizations see record-setting profits at the height of a global pandemic, rural communities across the state are experiencing unsustainable strain in their health care systems due to lack of resources,” Koehler said. “The money recouped through this legislation would provide immediate relief for Downstate hospitals that have been devastated by COVID-19.”

Hospitals across the state are facing an unprecedented decline in outpatient procedures and elective surgeries as a result of the pandemic, contributing to severe financial strain on health care facilities that serve Illinois’ most vulnerable populations. Conversely, MCOs in Illinois have benefitted from these declines, as enrollment-based payments have continued despite decreased use of non-emergency health care services.

In response, Koehler and Crespo introduced Senate Bill 4207 and House Bill 5867, respectively, which seeks to reallocate a portion of enrollment-based payments made to Medicaid MCOs throughout the pandemic. From an estimated monthly payment of $1.7 billion, a 20% return would yield $340 million per month that can provide needed relief to hospitals and other health care facilities that have been hit hardest by the COVID-19 crisis. In addition, recouping these funds can provide relief to health care service providers that may be impacted by state budget deficits.

“While safety net and critical care providers are struggling to remain open and serve their communities, MCO’s are continuing to receive over a billion dollars in state and federal funding each month,” said Crespo. “Residents across Illinois are making significant sacrifices in order to protect themselves and their communities, and we’ve even seen the auto insurance and cable television industries return unused money to consumers. It is unacceptable that MCO’s are profiting off of taxpayer dollars that aren’t being used. Clawing back some of the funding that MCO’s have received throughout the pandemic and reallocating those dollars to health care providers in low-income and rural communities could help hospitals remain open amid ongoing financial instability that has been exacerbated by the pandemic.”

* This is how Rep. Crespo explained the bill to WTTW

“We know that hospitals have not been doing services they normally do, elective surgery,” Crespo said. “So costs have gone down. So the plan here is to say, we should take back 20% of (the managed care organizations’) profits and redirect it to other Medicaid expenses the state has.”

Except he’s not talking about clawing back profits, necessarily. But, yeah, if they’re profiting off of a shift in the types of care provided, they should definitely lose that money.

*** UPDATE *** From Samantha Olds Frey, CEO, Illinois Association of Medicaid Health Plans…

The State of Illinois already has an existing mechanism to protect taxpayers and state from overpaying for underutilization and for 2020 requires that approximately 90% of the capitation received is spent on direct medical care.

While we have seen a shift in utilization we have not seen a 20% decrease in total medical costs for the Medicaid program.

It is important to note that MCOs don’t just pay for hospitals but a comprehensive healthcare benefit; such as: pharmaceuticals, long term care, and behavioral health. The proposed legislation would reduce the necessary resources to the Medicaid program and negatively impact providers and actually harm our most vulnerable residents. IAMHP is opposed to cutting a healthcare program for over 2 million people by 20% especially in the middle of a pandemic.

* Press release…

Illinois legislators and renewable energy businesses are calling for urgent action to save the state’s solar and wind energy jobs, and a new economic analysis shows that the proposed Path to 100 Act would not only save current jobs but would create more than 50,000 new jobs and $8.7 billion in increased economic output by 2033.

On December 4th, the Illinois Power Agency announced the close of state renewable energy incentives for residents in central and southern Illinois. With funding expected to disappear in northern Illinois in coming days, Illinois’ renewable energy program will abruptly end before the end of this year. The end of incentives will immediately impact the ability of homeowners and businesses to go solar and will force thousands of layoffs at solar businesses across the state in the coming months.

Senator Bill Cunningham and Representative Will Davis introduced the Path to 100 Act in early 2019 to address Illinois’ looming renewable energy crisis. The Path to 100 Act would improve and expand Illinois’ existing renewable energy program to allow the state to reach 40% renewable energy by 2030.

A new economic impact analysis of the Path to 100 Act found that, by 2033, the legislation would result in:

    • 53,298 jobs created or supported during construction
    • 3,215 jobs created or supported annually during operations
    • $8.27 billion in increased economic output during construction
    • $571 million per year in increased economic output during operations

The analysis was conducted by Dr. David Loomis. Loomis is the co-founder of the Center for Renewable Energy at Illinois State University and the President of Strategic Economic Research and has over 20 years of experience in energy and economic development analysis.

“Fixing Illinois renewable energy program is low-hanging fruit for the General Assembly and should be a top priority – we have a proven way to create jobs, benefit consumers and reduce pollution as well as a backlog of projects that could provide a rapid economic stimulus across the state,” said Representative Will Davis, House Sponsor of the Path to 100 Act. “There is no reason to delay fixing this.”

The report is here.

- Posted by Rich Miller        

  1. - yeah... - Thursday, Dec 10, 20 @ 11:21 am:

    But isn’t the fundamental bargain of managed care that the state pays a flat amount per enrollee per month and the insurance company has to make it work?

    Seems like this is changing the deal after the fact.

  2. - Carol - Thursday, Dec 10, 20 @ 11:22 am:

    The Crespo/Koehler Bill seems like a great away to fund some of the items in the Black Caucus’ health care pillar. It may also help avoid some of the cuts the Gov has recently alluded to it. This seems like a win, win.

  3. - Rich Miller - Thursday, Dec 10, 20 @ 11:24 am:

    ===seems like a great away to fund===

    Only if it’s real money. I’m not sure it is yet.

  4. - MakePoliticsCoolAgain - Thursday, Dec 10, 20 @ 11:26 am:

    I’m all in on someone finally holding the MCOs accountable. They take billions from the state and don’t even do the basics like ensuring their clients’ nutritional needs are met. The MCOs are going to try and do so much spin on this, but they won’t be able to escape from their dividends doing so well during a pandemic.

  5. - Third Reading - Thursday, Dec 10, 20 @ 11:37 am:

    Always risky to predict the General Assembly, but I’m almost 100% certain Senate Bill 4207 and House Bill 5867 won’t pass and become law during the 101st GA.

  6. - Dotnonymous - Thursday, Dec 10, 20 @ 12:13 pm:

    MCO’s were always about the money…not care.

    They charge a monthly fee for every participant instead of fee for each service…for what?

    If it isn’t a hustle…it isn’t Illinois?

  7. - Downstate Illinois - Thursday, Dec 10, 20 @ 12:46 pm:

    Well the lack of green energy scams is one bit of good news. Illinois is currently the third largest energy exporting state. Let’s keep it that way rather than switch to inefficient, expensive and unreliable green energy. We need cheap reliable energy solar and wind are anything but.

  8. - DuPage - Thursday, Dec 10, 20 @ 12:57 pm:

    They should require the state retiree and Trail insurance to return their excess profits and then use that money to catch up on the states late payments on the state retiree dental plan. A lot of dentists now demand state retirees pay in full up front.

  9. - illinoyed - Thursday, Dec 10, 20 @ 2:49 pm:

    @downstate illinois - your info on the cost of renewable energy is completely incorrect, you can ask the CFO of an Illinois school district saving $270 k a year with solar, or the International Energy Agency

  10. - Perrid - Thursday, Dec 10, 20 @ 2:59 pm:

    Until someone can explain to me how this is different from the MLR, the Medical Loss Ratio, which basically means the MCOs have to spend 85% of the money paid to them on medical costs or they have to pay it back to the state, I’m going to assume this is just bluster.

  11. - Interested Party - Thursday, Dec 10, 20 @ 7:33 pm:

    Perrid is right - it’s all about the Medical Loss Ratio. While MCOs may not have been paying for elective procedures, they’re paying more for telehealth visits than pre-COVID, paying for thousands of COVID hospitalizations (higher cost care than most elective procedures), and covering testing costs. I’m betting their MLRs aren’t down much if at all. And if they are, there’s already a clawback. And in fairness, MCOs also are now paying an assessment to the state of over $600 million; unlike the hospital assessment, MCOs aren’t getting that money back in payment for services.

Sorry, comments for this post are now closed.

* Special legislative session won't be held this month
* Taking another day
* SUBSCRIBERS ONLY - Today's special edition of Capitol Fax (use last week's password)
* Highland Park parade updates
* Reader comments closed for the holiday weekend
* Pritzker campaign spending $200K on cable/satellite TV in the next week
* Pritzker wants four things from Biden on abortion issue
* Construction group warns that strike "is now threatening the viability of our summer construction season"
* Campaign notebook: Lipinski's indy bid; Budzinski's million; DeVore's gun raffle; Pritzker on Republicans; Bailey says he's in the middle; Pritzker on Miller-Davis; SDem loss
* SUBSCRIBERS ONLY - Session update
* Illinois' version of "The Big Lie" is hilariously pathetic, but points to a bigger problem
* SUBSCRIBERS ONLY - Campaign report
* Question of the day
* *** UPDATED x1 *** Pritzker pounces on Bailey "biblical marriage" comments
* Dem pols praise "historic night" for Asian American/Pacific Islander candidates
* Today's quotable
* SUBSCRIBERS ONLY - Supplement to today’s edition (fixed password)
* Comptroller says state ends fiscal year with a GRF bill payment cycle of zero days
* Open thread
* SUBSCRIBERS ONLY - Today's edition of Capitol Fax (use all CAPS in password)
* Yesterday's stories

Visit our advertisers...







Main Menu
Pundit rankings
Subscriber Content
Blagojevich Trial
Updated Posts

July 2022
June 2022
May 2022
April 2022
March 2022
February 2022
January 2022
December 2021
November 2021
October 2021
September 2021
August 2021
July 2021
June 2021
May 2021
April 2021
March 2021
February 2021
January 2021
December 2020
November 2020
October 2020
September 2020
August 2020
July 2020
June 2020
May 2020
April 2020
March 2020
February 2020
January 2020
December 2019
November 2019
October 2019
September 2019
August 2019
July 2019
June 2019
May 2019
April 2019
March 2019
February 2019
January 2019
December 2018
November 2018
October 2018
September 2018
August 2018
July 2018
June 2018
May 2018
April 2018
March 2018
February 2018
January 2018
December 2017
November 2017
October 2017
September 2017
August 2017
July 2017
June 2017
May 2017
April 2017
March 2017
February 2017
January 2017
December 2016
November 2016
October 2016
September 2016
August 2016
July 2016
June 2016
May 2016
April 2016
March 2016
February 2016
January 2016
December 2015
November 2015
October 2015
September 2015
August 2015
July 2015
June 2015
May 2015
April 2015
March 2015
February 2015
January 2015
December 2014
November 2014
October 2014
September 2014
August 2014
July 2014
June 2014
May 2014
April 2014
March 2014
February 2014
January 2014
December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
October 2011
September 2011
August 2011
July 2011
June 2011
May 2011
April 2011
March 2011
February 2011
January 2011
December 2010
November 2010
October 2010
September 2010
August 2010
July 2010
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
June 2009
May 2009
April 2009
March 2009
February 2009
January 2009
December 2008
November 2008
October 2008
September 2008
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
September 2007
August 2007
July 2007
June 2007
May 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
August 2006
July 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
April 2005
March 2005
February 2005
January 2005
December 2004
November 2004
October 2004

Blog*Spot Archives
November 2005
October 2005
September 2005
August 2005
July 2005
June 2005
May 2005


RSS Feed 2.0
Comments RSS 2.0

Hosted by MCS SUBSCRIBE to Capitol Fax Advertise Here Mobile Version Contact Rich Miller