Report: Chicago's Medicaid Expansion Faces $64 Million Shortfall

Tuesday, 15 Jul 2014 03:58 PM

By Jennifer G. Hickey

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CountyCare, Chicago's managed care system for Medicaid, is facing a massive shortfall as program expenses exceeded revenues by $21 million in the first six months of the fiscal year, reports The Chicago Tribune.

And it gets worse, as officials anticipate that shortfall will grow to $63.5 million by November 30, the end of the fiscal year.

CountyCare began in 2013 as an early expansion of Medicaid to low-income adults who would be eligible under Obamacare.

Under the Affordable Care Act, states have been given the authority to decide whether to expand eligibility for their Medicaid programs to cover anyone below the eligibility threshold for ACA subsidies.

While the program has allowed about 95.000 people to enroll for health insurance for the first time, costs have ballooned as those patients have chosen to take advantage of "everything from checkups to pricey treatment for chronic ailments," reports Crain's Chicago Business Journal.

Dr. John Jay Shannon, who was picked to lead the Cook County Health and Hospitals System in June, is responsible for identifying $67 million in savings in the next four months. To achieve that goal, Crain's reports, Shannon hopes to be able to move higher-risk patients toward preventative care and out of emergency rooms.

However, beginning in January, patients enrolled in CountyCare will have the option to choose other health plans. Initially, all patients were required to use CountyCare clinics and other facilities.

If too many patients leave, the public health system will have to deal with the most complicated and costliest patients who lack insurance.

Earlier this year, Republican Sen. Mark Kirk criticized the state's expansion of Medicaid, questioning whether people were being misled into believing that Medicaid was equivalent to having health insurance.

"The question is, is their family actually going to be covered? And the answer is no — that when you show up and find out the doctor says, 'No I don't take Medicaid because the . . . payments are too slow and the state of Illinois is too incompetent to run this," Kirk said, the Tribune reports.

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