Illinois House passes changes to Medicaid
GOP lawmakers debated two Medicaid bills last month before passing both with little opposition.
HB 4096, sponsored by Sen. Heather Steans (D-Chicago), amends the public health code and prohibits Medicaid Care Organizations (MCO) from using a preferred drug list that differs from the Department of Healthcare and Family Services (DHFS).
During the debate, Steans said she did not anticipate a cost for the state but it was intended to ensure patients with complex illness have access to more medication options.
Sen. Dave Syverson (R-Rockford) disagreed with Steans, arguing DHFS estimated a price tag around $20 million, which is possibly why they oppose the bill, he said.
“[HB 4096] is taking away that ability to negotiate a single contract as opposed to each MCO having their own prescription contract,” he said.
Steans disagreed with Syverson’s assessment regarding DHFS’ cost projections for the bill.
“We never got that number from DHFS,” she said. “Perhaps there is some future savings amount they feel they can achieve if we are under this in terms of some rebate losses.”
DHFS does not like to limit MCOs and are possibly philosophically opposed to the bill in that regard, Steans said.
Sen. Dale Righter (R-Mattoon) argued that the bill would change current policy.
“Different Managed Care Operations have different preferred drug lists and that is one of the flexibilities that we accepted when we said we wanted to go to Managed Care,” he said. “This will require them to adhere to one standard.”
However, Steans pointed out that MCOs support the bill, which implies it will not create additional costs. HB 4096 passed 47-9.
The House then debated HB 4736, sponsored by Sen. David Koehler (D-Peoria). The bill prohibits DHFS from requiring medically fragile children on Medicaid to enroll or transition to a state medical managed care program.
To show her support, co-sponsor Sen. Pam Althoff (R-McHenry) asked Koehler to note exactly how many children are affected by the bill.
“The answer is 945,” Koehler said.
Before he cast his vote, Righter sought clarity on the bill, asking what Koehler’s primary reason for sponsoring the bill, as well as the ability of patients to opt out of the process.
Citing any disruption of services for a medically fragile child as his biggest fear, Koehler also mentioned the negative impact on a patient if they have to change plans, equipment or home care.
Sen. John Curran (R-Downers Grove), who has worked with at-risk children, thanked Koehler for his work on the bill.
"One of the children I worked with had a problem with MCOs, and there was tremendous disruption with specialists and approvals," Curran said. "I think this is a very important bill."
HB 4736 passed 90-1.