The Insanity of Illinois Medicaid

Member carewemust put up an article on a different thread and it has some real "awakening" news about Medicaid.

Apparently Illinois has been moving medicaid patients into managed care insurance policies run by private companies like Blue Cross, Aetna, etc.

An article from Aug 11th outlines how the State is going to "save" money with some new "guidelines".

The eye-popping part of the story is Illinois has 3.2 million people on Medicaid, and the State is something like $3 billion behind in payments to the insurance companies.

Illinois has a population of maybe 12.8 million.


So why are 25% of the population qualifying for Medicaid?

Are other states like this ?


("Rauner" is the Governor of Illinois and is a Republican)
Rauner names winners in Medicaid overhaul

The Rauner administration has awarded bids to six insurers in his quest to overhaul a major Medicaid cost-saving initiative, cutting in half the number of participating carriers.

The winners are Blue Cross & Blue Shield of Illinois, the largest carrier in the state, and the following insurers affiliated with national or regional carriers: Harmony Health Plan, IlliniCare Health Plan, Molina Healthcare of Illinois and Meridian Health, according to the Illinois Department of Healthcare and Family Services, which implements the Medicaid health insurance program for the poor and disabled. They will administer medical benefits to Medicaid recipients statewide.

Also winning is CountyCare, a health plan run by the Cook County Health & Hospitals System, that will operate in Cook County only. IlliniCare also will cover children in the custody of the Illinois Department of Children and Family Services.

In total, nine health plans bid for contracts to oversee the coverage of most of the state's 3.2 million recipients on Medicaid.

a reply to: xuenchen

Illinois is the worst, in that it is about broke and, guess what, the only saving will be for Uncle to step in. Illinois is another state controlled by a major city, Chicago in this case. It is nicknamed "The State of Chicago." Heavily controlled by the democrats on the top level and several shades of mobs below. The downstate folks were able to elect a Republican governor after two former governors went to and remain in prison. Still, that caused a loggerhead of problems. The most recent being that a school funding bill didn't pass last week and school in some areas may not open in time or at all. Pension funds are running dry across the state and a bailout is necessary and must come.

I'll wager that once Medicaid is turned over to the private companies the state will be directly relieved of being in charge of any drastic cuts in services the independents will introduce. It is a given that services will suffer greatly. I personally know of three Blue Cross employees that recently have been terminated due to Blue Cross trimming its staff.

a reply to: xuenchen
Let me cogitate a moment... Please correct me if I've got my sums wrong. Illinois has 12.8 million people, say 12 million. The government are paying insurance companies 3 billion. Now what if the government short cuts the insurance companies and pays the hospital direct. This would equate to 230 per person.
Now if only 3.2 million are using the system that would equate to nearly a million per person. Again I'll ask the same question "just why do you suffer paying insurance companies the lions share of your health care provisions"?

a reply to: xuenchen

im guessing most of these people are older/retired people and lazy/bi-polar conartists. single pregnant poor women, im betting alot of them in illinois as well. and of course the corrupt politicians getting the majority of this money. i voted for Rauner even though i don't like him. im hopeing he can turn this state arround. i know so far he has rejected every proposal that was set to give most to chicago and pork money for those making the proposal. i still got my fingers crossed.

originally posted by: crayzeed
a reply to: xuenchen
Let me cogitate a moment... Please correct me if I've got my sums wrong. Illinois has 12.8 million people, say 12 million. The government are paying insurance companies 3 billion. Now what if the government short cuts the insurance companies and pays the hospital direct. This would equate to 230 per person.
Now if only 3.2 million are using the system that would equate to nearly a million per person. Again I'll ask the same question "just why do you suffer paying insurance companies the lions share of your health care provisions"?

Well first, the "$3 billion" is what the State owes. We don't know how long a timeframe that is.

And, $1 million per person would equal $3.2 Trillion.

And, I think Illinois was paying direct for many years.

They're still broke any way you look at it.

And, the whole system here is nuts.

a reply to: crayzeed


Waste and fraud is rampant and staggering. Add to that, anyone who earns under $16,000 a year can be on Illinois Medicaid, due to ObamaCare Medicaid expansion. In my section of the Chicago metro area, only 6 physicians accept Medicaid...down from 17, because the state fell more than a year behind in reimbursing insurers.

originally posted by: xuenchen

originally posted by: crayzeed
a reply to: xuenchen
Let me cogitate a moment... Please correct me if I've got my sums wrong. Illinois has 12.8 million people, say 12 million. The government are paying insurance companies 3 billion. Now what if the government short cuts the insurance companies and pays the hospital direct. This would equate to 230 per person.
Now if only 3.2 million are using the system that would equate to nearly a million per person. Again I'll ask the same question "just why do you suffer paying insurance companies the lions share of your health care provisions"?

Well first, the "$3 billion" is what the State owes. We don't know how long a timeframe that is.

They're still broke any way you look at it.

And, the whole system here is nuts.

I was surprised yesterday to see 20 cents added to each lemonade our group ordered at a restaurant. I thought the "sugar tax" was only for the city of Chicago. Didn't know the entirety of Cook County was affected. No wonder +2,000 individuals and families move out of this state every month!

Meanwhile the hoochies from Wisconsin move to Illinois for the expanded free ObamaCare Medicaid. Add illegal aliens seeking sanctuary, and the random shootings now occurring on the expressways, and you're looking at a serious death spiral.

a reply to: xuenchen

Wife and I have full health care coverage ie: Medicaid /Blue Cross Complete. We pay 0$ for anytthing, tests, scripts-no deductibles.

Based on combined yearly income below $25k for married couple, both working part time... Blue Cross Complete/primary... MiHealth picks up difference. BCComplete is not BCBShield... but Medicaid based only.

Michigan.

MS

a reply to: mysterioustranger

Do you know if Michigan is having trouble "paying" the insurance companies involved ?

Illinois is deep behind.

Doctors and "Networks" are limiting "new" patients too lately.

(according to people on the Illinois Medicaid plans)

originally posted by: carewemust
a reply to: crayzeed


Waste and fraud is rampant and staggering. Add to that, anyone who earns under $16,000 a year can be on Illinois Medicaid, due to ObamaCare Medicaid expansion. In my section of the Chicago metro area, only 6 physicians accept Medicaid...down from 17, because the state fell more than a year behind in reimbursing insurers.

Anyone who earns under 16K a year SHOULD be eligible for IL Medicaid. You can't effin live on that. I checked prices all over IL, not just Chicago - which by the way is outrageous in housing prices.

OUTSIDE of the Chicago area:

Min 10k a year for a 1 br apt
2400 a year for car payments and ins, and that's low balling to the max
phone/cable/internet 1500/yr
Gasoline 1200/yr
Food 1800/yr
Util 3,000/yr

Yeah okay, looks great, NOT. Can't afford food so knock that out, knock out gas and take the bus which is still an expense. It's ridiculous that someone should not be on Medicaid at that income level with even below average living expenses, they certainly couldn't afford an additional 2500 -4500 a year for medical premiums.

But on topic, waste and fraud is rampant in so many states because there are no checks and balances, or very few. It's disgusting how most politicians aren't in it for the people, they're in it for the money. I'd wager at least 90% of all of them are anyway.