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Sunday, September 23, 2012

They took all the trees


Engineering Drive.

* The State of Illinois recently enacted a law to save $1.6 billion by cutting Medicaid spending. The law is called “Save Medicaid Access and Resources Together Act," or SMART, for short. The SJ-R is reporting on the law in a three-part series this week, the first of which was today: Uncertainty surrounds impact of Medicaid cuts.

Just because you call something SMART, doesn't mean it is.

“The Illinois Medicaid system was on the brink of collapse, and we needed to identify $2.7 billion in savings to save the system,” said Mike Claffey, spokesman for the Illinois Department of Healthcare and Family Services. “Without solving the Medicaid crisis this spring, the program would have continued to eat into the state’s ability to fund critical state priorities, including education and public-safety officers.”
In addition to the $1.6 billion in cuts and savings from the SMART Act, the legislature and Democratic governor generated the remaining $1.1 billion with a cigarette-tax increase for $700 million, which includes a federal match, $100 million from a new hospital assessment program and $300 million from increases in expected state revenues.

So, to save $2.7 billion, they cut $1.6 billion, and the rest of the savings is going to come from new revenue. You have to wonder if they just put $2.7 billion in new revenue into the program, would they call that savings?

And then there's this:

An estimated 7,000 people 60 and older would fail to qualify for the Illinois Department on Aging’s Community Care program this fiscal year, saving the state $26 million, based on the SMART Act’s change in eligibility guidelines.
The change, which hasn’t yet received approval from federal officials, also would affect guidelines on who would qualify for Medicaid coverage for nursing-home care.
State officials said people truly in need still would be admitted to Community Care, but Vinkler said the eligibility change would put more people at risk of being denied needed at-home services. Those people then might have to enter a nursing home, where care is more expensive for the state to subsidize, he said.

Again, you have to wonder if full-time nursing home care costs more than in-home care, where is the savings. The numbers aren't in yet, but perhaps they're counting on people opting out of any care.

This was in the comments:

A couple of years ago, the state decided they would no longer pick up the co-pay/deductible of the disabled who were on their parents' private pay insurance and had a medical card as a supplemental. If they did not have private pay, their medical card covered any necessary treatments. It was a no brainer for parents to drop their family member from their private pay. Most private pay programs were an 80/20 policy. Instead of picking up a $20 co-pay/deductible, now the state pays for all coverage.

If true, and I have no reason to doubt it, you have to wonder how much thought and discussion went into that idea.

Finally, of the 21% of Illinoisans enrolled in Medicaid, these are them:
* Children — 1.7 million
* Disabled adults — 260,000
* Seniors — 169,000
* Other adults — 636,531

Putting dollar amounts with those numbers would be valuable information.

* And put 'em in a tree museum and they charged all the people a dollar and a half just to see 'em.

Posted by Marie at September 23, 2012 9:12 PM


What will happen to the people that qualified under the old terms but will no longer qualify under the new terms?

Posted by: Allie Carnes Author Profile Page at September 23, 2012 11:50 PM

For the most part, they'll have to find a way to pay out of their own pocket.

Posted by: Marie Author Profile Page at September 23, 2012 11:55 PM

We have a governor here in Louisiana, who just loves to cut Medicaid. It's how he earned his chops in Republican circles. The old Fram oil filter commercial comes to mind. You can pay me now or pay me later.

Posted by: Rob Author Profile Page at September 24, 2012 6:49 AM

The weird thing here, Rob, is these are all Democrats. I understand they want to make cuts, but some of them are totally ridiculous.

Posted by: Marie Author Profile Page at September 24, 2012 10:32 PM

Cutting assistance to the poor is popular but I don't think it's particularly smart or economical most of the time. Setting aside what it says about us as a society, it intensifies hopelessness and desperation. Assisting is expensive but I think it's more expensive not to.

Posted by: Rob Author Profile Page at September 25, 2012 12:41 PM

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