Currently, Illinois’ Medicaid program costs more than $10.6 billion per year and continues to grow at a rate far outpacing state revenues. As a result, many medical providers wait months before they are reimbursed by the state for services provided to Medicaid patients. The payment backlog has led to financial hardships for the providers and serious access issues for Medicaid patients.
REFORMS SUGGESTED BY SENATE GOP
Senate Republicans have advocated transitioning to a managed care system, which would establish a primary “medical home” for Medicaid recipients. Nationally, states have been moving toward managed care, where patients have physicians who are responsible for monitoring and managing their care. Research has found that adopting managed care principles often translates into better care for the patients, while reducing costs to the state.
The Senate GOP is also advocating the state tighten existing Medicaid eligibility guidelines. Currently Medicaid applicants need only provide one pay stub to determine their annual income for eligibility purposes. Additionally, a Medicaid applicant is presumed eligible for the program before his or her eligibility is determined by the state, meaning taxpayers may incur medical costs for individuals who are not even eligible.
Senate Republicans also say the state needs to review and reform Illinois’ process of re-determining Medicaid eligibility and incorporate asset testing into eligibility criteria.
CHANGES ALSO NEEDED FOR WORKERS’ COMP
Senate Republicans have also been pushing for workers’ compensation reforms in order to reduce costs for business and industry, and make Illinois more cost-competitive.
Currently, Illinois is the third highest in the nation when comparing workers’ compensation insurance costs to employers. This rate puts Illinois at a competitive disadvantage, especially compared to surrounding states that have very low workers’ compensation rates.
The business community has in the past proposed several reforms they believe would reduce workers’ compensation rates, including establishing a primary cause standard, requiring the workplace to be the principal cause of an injury.
Other suggested reforms include tightening impartiality requirements for arbitrators and commissioners, who interpret the Workers’ Compensation Act; tightening standards for injuries caused by alcohol or drug abuse on the job; and establishing objective medical standards when determining permanent partial or total disability.
REPUBLICANS ASK GOVERNOR ABOUT PROGRAM
The Senate Republican Caucus is asking the Governor to provide lawmakers with more information on the recent extension a $47 million extension of “Put Illinois to Work” program. At a time when Illinois owes approximately $9 billion in overdue bills and faces a massive deficit, some estimate at roughly $15 billion, it is important to assess whether the program is the most effective way to create the good-paying, permanent jobs that Illinois needs.
Republican lawmakers found it particularly troublesome that Quinn intends to use funds from a recent tobacco settlement to cover the cost of the expansion. The Governor’s plan to use those funds may be a violation of both the letter and intent of a law enacted to authorize the use of tobacco settlement funds for reducing the state’s backlog of overdue bills. Additionally, the six-week extension will cost taxpayers for the next 18 years, at a ratio of more than 145 days of debt for every one day of the program.
PENSION REFORM APPROVED
Lawmakers did approve an important pension reform measure, which will provide much-needed relief for municipalities buckling under the cost of funding police and fire fighter pensions.
Current employees will not be affected by the bill, but under Senate Bill 3538 new hires would have to work to age 55, instead of 50, with 10 years of service. Individuals with 10 years of service can retire at age 50 with reduced benefits.
The measure also addresses the end-of-career “pension bump,” in which a retiring employee's benefits are boosted by receiving a major pay hike just before retiring. Senate Bill 3538 stipulates that the employee’s final average salary would be calculated based off the highest 8 years out of the last 10 years, instead of based on the last day of pay. The maximum salary used to consider benefits would be capped at $106,800.
Cities and municipalities are also expected to chip in; the bill requires 90 percent of their obligations be covered by 2040. Municipalities that fail to contribute the required amounts would see state grants withheld beginning in 2016. Gov. Quinn, however, has not said if he will sign the measure even though it passed with strong bipartisan support in both chambers.
GAMING BILL ADVANCED
The Senate sent a substantial gaming expansion bill to the House. Senate Bill 737 would allow for a Chicago casino, four new riverboats, slot machines at Illinois’ six racetracks, and increase the cap on positions at current boats.
Some lawmakers expressed concerns that additional casinos would siphon revenues away from the state’s existing casinos. Others noted that a gaming expansion is not a dependable source of revenue, and urged lawmakers to look to cuts and reforms as a way to boost state coffers. Proponents said the expansion would create much-need revenues, while bringing both construction jobs and permanent positions to the state.
REDISTRICTING BILL LACKS TRUE REFORMS
On December 1, the Senate passed redistricting reform legislation. Important transparency measures, advocated by “good government” groups and advanced by Senate Republicans this year, were not included.
Senate Bill 3976 passed the Illinois Senate and now moves to the House for consideration.
The measure advances protections to minority voting rights, but does not make significant improvements in giving the public greater access to, and information about, the redistricting process.