Quinn Medicaid deal regrettable

Quinn Medicaid deal regrettable

A sensible plan to hire an outside firm to remove ineligible recipients from Medicaid rolls has been abandoned under union pressure.

Many people who hear that the once-great state of Illinois is in a death spiral may wonder what that means.

In two words: effective bankruptcy. The longer explanation is that without dramatic changes in how it does business Illinois will no longer have the money to carry out the state's core functions — such as funding education and law enforcement, and fixing roads and highways.

The fact is that pension and Medicare obligations are eating up state dollars, and Gov. Pat Quinn and legislators have been trying to figure out how to reduce the growing costs of those two programs so that basic state functions can be maintained.

But it's a hard slog.

Earlier this month, legislators passed and Quinn signed a bill that, if it survives a court challenge, will change the way future pension benefits are calculated. Time will tell if things work out.

Regarding Medicaid, legislators made changes there, too. But the story of Medicaid in Illinois demonstrates that in this state it's too often one step forward and two steps back.

Consider one of the key reforms that legislators implemented. They decided to ensure that people who do not qualify for Medicaid under the state's rules would be removed from the Medicaid rolls. Those who were targeted for removal include residents of other states who are receiving Medicaid benefits from Illinois.

That's all you need to know to understand the depths of this problem. Since when is it reform to deny residents of other states benefits from Illinois programs?

State officials hired a private company, Maximus, to conduct a review of the Medicaid rolls, and their initial efforts identified 127,000 cases of 316,000 cases that were reviewed where ineligible recipients were collecting costly state benefits.

Obviously, Maximus is operating in a target-rich environment. Based on those findings, costly fraud apparently is rampant in Medicaid.

Not everyone, however, was pleased by the Maximus results, specifically the union employees who work in the Department of Healthcare and Family Services.

They filed a complaint alleging that the state improperly hired an outside contractor when it should have relied on state employees to conduct the review of the Medicaid rolls. An arbitrator ruled in favor of the union, setting the stage for the dismissal of Maximus.

Quinn could have appealed the decision, and, in our view, should have appealed it. Instead, he negotiated a settlement with the union whereby the Maximus contract will be terminated on April 30.

From a taxpayer standpoint, this is a most disturbing result.

For starters, the same department overseers who were so incompetent or indifferent that they allowed many thousands of ineligible people to receive Medicaid benefits now will be assigned to lead a cleanup of the rolls.

Then, assuming the arbitrator's ruling had merit, there is the matter of state officials bargaining away their management authority in a way that makes it difficult to bring in an outside group to identify and solve a major problem created by the existing state bureaucracy. Those who suspect public employee unions have too much power and use that power to act in their own self-interest, rather than the public interest, have evidence for that proposition in this case.

Since this is Illinois, politics also is in play. Quinn's pension legislation enraged union members in the face of an upcoming election year. So it would be no great surprise if he sought to smooth their ruffled feathers by pulling the plug on Maximus.

Quinn denied any political motive, saying he settled because he didn't "want to spend the rest of my life in court."

The fact, however, is that appealing the arbitrator's ruling wouldn't have required him to spend the rest of his life in court or anything approximating that. Indeed, Quinn's statement is just hyperbole that evades the issue.

Nonetheless, the matter is settled. A program that was working in the public's interest has been set aside for reasons that make no sense.

Remember the Medicaid fiasco the next time you hear someone say the state is in a death spiral. It's Exhibit A for what ails the Land of Lincoln.

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Sid Saltfork wrote on December 29, 2013 at 8:12 am

The answer is so obvious to those who do not do any homework on the issue.  Maximus has been "politically contracted" for all sorts of public service work in the past.  Maximus hires staff, and trains them when they need they as a contract arises.  The previous experience with Maximus is that much of their work has to be redone by public employees.  I am speaking from experience on Maximus' work performance.  Generally, the top is skimmed for violators to be followed by sloppy documentation, or no documentation.  The contracts with Maximus, a private firm, generally come with a "campaign donation" from the company to the director, or politician who secures the contract.  The public should know that any program utilizing any federal money can be audited by the feds.  That is where the documentation comes in.  Maximus has a poor track record in documentation.  Ask public employees who worked with Maximus how many times they had to redo Maximus' work.  It all looks so obivious on the surface to the media who do not bother to investigate; but do not hesitate to draw conclusions.  

Just another public employee hating article in a long line of others by the one, and only paper in an area of thousands of public employees.  It is puzzling why the paper trashs it's own readers.  Must be the '50's conservative attitude that still hangs over it. 

rsp wrote on December 29, 2013 at 10:12 am

Maybe part of the reason all those people were on the rolls, if they are in fact ineligible, is because of all those cuts to the welfare budget that removed the people who actually did the paperwork. You know, the people who review cases. First we make it almost impossible to do your job then we complain about the mistakes. Same thing happens with DCFS and every other program.