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Distorting reality

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Illinois

* Bruce Rauner on cleaning up government…

Avoiding discussion of recent ACA woes Rauner said, “Medicaid in Illinois is completely out of control. An investigation of 20,600 enrollees proved that 50 percent were not eligible for Medicaid benefits. I am going to reform that system. Quinn has been dramatically expanding it.”

Actually, the investigation Rauner referenced is part of the reforms already in place and signed into law by Gov. Quinn.

* Rauner is basically repeating some talking points by the Illinois Policy Institute, although his numbers are outdated. The group has been screaming about the termination numbers for weeks as proof that Illinois’ Medicaid system is rife with fraud. A recent IL Policy Institute story was entitled “Half of Illinois Medicaid enrollees reviewed found ineligible”…

Since January, the [state’s] independent vendor has reviewed nearly 419,000 case files of individuals currently enrolled in Medicaid. Of those, the vendor identified more than 210,000 that were ineligible for benefits, which amounts to more than 50 percent of all cases reviewed so far.

* As usual, of course, it’s ideology first, actual facts second for those guys. The reality is, the Department of Healthcare and Family Services initially pointed the contractor Maximus to the lowest hanging fruit, so the termination numbers will initially be high because those are the folks who are suspicious to begin with.

And lots and lots of cases were terminated simply because recipients failed to respond to a paper work request. Here’s the HFS explanation about what those Maximus contractor numbers (click here to see the most recent) actually mean…

· For all cases to date, Maximus has recommended canceling just under 50%. It is down from earlier percentages because, we started out cases that were flagged as having the highest likelihood of being ineligible (such as having a discrepancy in data or not reviewed for a long time). Almost all the cases they have worked the entire year are still cases that we think have a “higher” likelihood of being ineligible, but we are moving down the chain of likelihood. The cases we have not reached are those with the least likelihood of being ineligible. About 75% of them were cancelled for failure to respond to a request for more information.

· Those are just recommendations by Maximus. In reality, the State is only cancelling about 39% of the cases. Under the SMART Act rules, Maximus gives 10 business days to return information. But caseworkers then have 20 further days to work cases. The main reason the State disagrees with the Maximus recommendation is the client shows up with additional information that establishes eligibility.

· Of these who are actually cancelled, about 20% are returned to the rolls fairly quickly because they finally turn up and provide the missing information. This gets us down to approximately about 32% of cases being cancelled so far.

· We believe this overstates the proportion of people ineligible because the above numbers only cover those cases that are Medical only…that is, they do not have SNAP. People are more attentive to their SNAP re-de’s because they would lose money immediately if they didn’t respond. (As opposed to only being impacted at some future time…and with the ability to get reinstated at that future time.)

· The bottom line is that we are cleaning up the rolls as we said we would – and this is important for the integrity of the program. However we also believe that the early results overstate the number of people who are ineligible and enrolled in the program. We do expect the percentage who are disenrolled to come down as we make it all way the way through the redetermination process.

There’s no doubt that people are indeed getting medical care provided by the state who shouldn’t be. But there is an ongoing effort to clean the rolls, despite the hype by folks who aren’t exactly Medicaid fans to begin with.

posted by Rich Miller
Wednesday, Nov 20, 13 @ 1:55 pm

Comments

Don’t want to begrudge Mr. Rauner because of all his money, though I would like much more of my own. God bless him. He worked hard, came from not a silver spoon in the fanny childhood (c.f. Andy McKenna) and made billions. But, there are just so many inconsistencies to the Mr. “Outsider” barn jacket persona that it is actually disturbing in the context of considering him as Governor. I hate to say it, there is just something about the guy.

As just reported by Greg Hinz: Four companies listing the same address — 4615 Northpark Drive, Suite 101 [Colorado] — each in recent days have donated $10,500 to the Rauner campaign, according to a state Board of Elections disclosure filed yesterday. The question is, why? And who?

http://www.chicagobusiness.com/article/20131120/BLOGS02/131129987/rauners-big-new-donor-someone-in-colorado?r=0351F6849023G9U

Comment by Samurai Wednesday, Nov 20, 13 @ 2:18 pm
===The question is, why? And who?===

I helped Greg figure out the answers to both. Check that post for an update soon.

Comment by Rich Miller Wednesday, Nov 20, 13 @ 2:22 pm
The sad irony is that Rauner’s so-called policy reform / school reform credentials are based on data and science based policy. Yet he continues to dumb down the debate and pretend he doesn’t know anything every time he speaks.

He comes across as phony and unlikeable every time. Honestly, at least Bill Brady actually is who he is.

Comment by Siriusly Wednesday, Nov 20, 13 @ 2:34 pm
Rich thank you for your thoughtful post on the Medicaid fraud issue. Since Mr. Rauner’s consultants had access to the same information you had one suspects he simply chose to ignore the more complex reality of this issue. None the less the idea that 50% of all Medicaid recipients are frauds is out there and Mr. Rauner seized on it.

Comment by Rod Wednesday, Nov 20, 13 @ 2:36 pm
Fascinated by Greg Hinz’ article. Looking forward to the update. But back on the original topic, I can’t tell you how horrible the Medicaid redetermination project has been for one of my clients. He has advanced AIDS, with CMV retinitis, which periodically causes him to go temporarily blind. He lives on a very small disability pension from a past employer. His benefits have been terminated three times this calendar year. In every case, he has sent in everything they demanded of him well before the deadline. In every case he was terminated anyway. In every case when he went and spent enough time in his local public aid office, the matter was fixed and he was reinstated. He’s probably spent 15-20 hours trying to stay on Medicaid this year. I’ve probably spent 10 trying to help him. Most recently, I went with him on a formal appeal of his termination. The person we met with looked at the form from Maximus and said “you didn’t send in these things.” The client pulled them out with proof that he had sent them. She reinstated his case. I have no reason to believe it’s fixed for good.

Comment by Ann Wednesday, Nov 20, 13 @ 2:43 pm
===Looking forward to the update===

It appears to be basically just a rich guy legally skirting the caps by writing checks from multiple entities he controls before the caps were off or before he knew they were off. Happens regularly and it’s legal.

Comment by Rich Miller Wednesday, Nov 20, 13 @ 2:49 pm
Meh, that’s just antics with semantics. Half of 419k is 210k, Rauner is absolutely correct in his basic math. If you want to accuse him of ignoring context or mitigating circumstances, fair enough, but his “facts” are not wrong as you imply.

Comment by Anonymous Wednesday, Nov 20, 13 @ 2:49 pm
God forbid, that people should have access to health care.

Comment by smarmy Wednesday, Nov 20, 13 @ 3:06 pm
Who’s Rauner going to bring to “reform” Medicaid, the guy from 7Wire who dropped a quarter million on him?

Comment by wordslinger Wednesday, Nov 20, 13 @ 3:16 pm
You stick Quinn, Rutherford, Dillard, or Brady in a bag, shake it up, pull one out at random and stick them in office. A year later you couldn’t tell the difference, they’re professional pols. But this guy? This guy does not have a genuine bone in his body. And it’s not the wardrobe changes, the Harley, the bird hunting with a double-barrel shotgun most can’t afford. No. This guy is a fake whether he is running for office, running a business, or running to the corner 7-11 for a gallon of milk. There simply is nothing of substance to this guy.

Comment by efudd Wednesday, Nov 20, 13 @ 3:44 pm
Just once I would like to see somone come out and say we need to find a system that makes sure medical care is available for everyone who needs it as the starting premise; not the everyone is a crook premise.

Or I would like the person demanding we limite or eliminate medical care to be an elected official who has voted to end health care fior elected officials on the governments dime….

Comment by Ghost Wednesday, Nov 20, 13 @ 3:49 pm
I assume when Rauner says “reform” he means cut back on Medicaid benefits. People like Rauner aren’t fond of those bad old social programs. He needs the money to help out his rich friends with tax breaks.

Comment by Demoralized Wednesday, Nov 20, 13 @ 4:05 pm
Rauner’s criticism might ignore context, and therefore be unfair to Quinn — but even so, the level of ineligibility already uncovered from the “low hanging fruit,” is very disturbing.

Comment by walkinfool Wednesday, Nov 20, 13 @ 4:09 pm
Wait, what? Rauner is playing politics with this? I thought he wasn’t a politician?

Huh. Sure had me fooled.

Comment by 47th Ward Wednesday, Nov 20, 13 @ 4:15 pm
Rauner’s schtick of “I’m a billionaire man of the people come to save Illinois” just rings false. The Emanuel and Democrat stuff is lethal to him south of I-80, and probably in parts north of that as well. He is easily painted as a rich ideologue, but one who never let his supposedly rock-hard principles stand in the way of making another buck.

Comment by Percival Wednesday, Nov 20, 13 @ 5:14 pm
Good grief… Even 32% is HUGE. It’s a little like quibbling whether someone drown in 8 feet of water or 10.

Comment by Right Field Wednesday, Nov 20, 13 @ 5:15 pm
Perhaps the most important thing to note about these Medicaid enrollees that Maximus is identifying and dis-enrolling is that most of these people are very low-end users. They’re not targeting the aged and disabled who account for around 70% of the Medicaid budget. Many of the dis-enrolled haven’t had a covered service in a very long time. So while HFS and DHS are culling large numbers from the rolls, that doesn’t really translate to lots of savings.

Comment by Budget Watcher Wednesday, Nov 20, 13 @ 6:23 pm
If you do a bit of digging you will find that 50 percent of those suspected of being ineligible were found ineligible. It is not 50 percent of all Medicaid recipients.

Also, a large proportion of those found ineligible because they no longer lived in Illinois had not actually used a Medicaid funded service since they left the state. Their names stayed on the list after they moved on.

The right wing think that all social programs are full of cheaters, but experience has shown that they are no more prone to fraud than middle class tax deductions or defense contracts. Some poor people cheat just like some rich people cheat.

Comment by DuPage Dave Wednesday, Nov 20, 13 @ 7:45 pm
Look to the Trib to take Rauner to task for his distortions ASAP.

Comment by Willie Stark Wednesday, Nov 20, 13 @ 8:24 pm