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The [Tuesday] Papers

"[T]ens of thousands of Illinois residents [have] been waiting months for access to health care as the state slogs through a backlog in determining who's eligible for Medicaid," the Sun-Times reports.

"As of March 15, more than 112,000 Illinois Medicaid applications remained unprocessed beyond the 45-day limit the federal government puts on those eligibility determinations."

I'm glad to see this story reported, but if the media cared about the life and death scenarios of society's most vulnerable as much as they occasionally pretend the government should care, this would be reported on daily just like, say, the ongoing union negotiations of a symphony orchestra. Perhaps a mayor might even step in vowing to get it resolved.

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"The federal Center for Medicare and Medicaid Services has warned state officials that Illinois is out of compliance with regulations on timely determinations of eligibility for the federally funded program to provide health coverage for low-income people and asked how they plan to fix that, records show."

Who will penalized for the state's non-compliance? Will folks be fired? Will meaningful fines ensue? Who will be held responsible, and how?

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"If a case is delayed past the federal time limit, Illinois Medicaid applicants are supposed to be able to get cards granting them temporary medical benefits. But those also are backlogged. The state's Medicaid application-processing delays and failure to issue temporary medical benefits have left some of Illinois' poorest residents without access to health care, in some cases for more than a year."

Let me restate that: Some of Illinois' poorest residences have been left without access to health care, in some cares for more than a year, through no fault of their own. They are suffering while life goes on for everybody else.

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"Illinois provided no temporary medical benefits at all between June 2016 and September 2017, state Department of Human Services records filed in federal court show."

Have people died because of this? I'm thinking people have died. But instead of, say, the drama of the Legionnaire's outbreak at the Quincy Veteran's Home, it's the kind of slow-motion outbreak of deaths occurring every day at the hands of a country (and state) that rations its health care to those who earn it on the merits of accumulating capital, no matter how that capital is acquired and who gets hurt in the process.

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"Jordan Abudayyeh, a spokeswoman for Gov. J.B. Pritzker, said: 'It is unacceptable that people across the state are waiting for healthcare coverage, and he has directed the administration to take immediate steps to address this problem from the previous administration.'"

And how does the governor expect that to happen? Will the governor step in himself, or just dish it off as its been dished off forever while he attends to more important priorities? The issue is so unimportant that he wouldn't speak to a reporter himself?

What if a governor actually put social service issues on top of their agenda? What if a governor came in and said, "We're going to help people first. It's not exciting, and in fact it's bureaucratic drudgery, but we're going to get our social services squared away. After that, I'll consider other issues before is."

That will never happen, because it's not happening to them.

"In a written statement, the heads of the Illinois Department of Healthcare and Family Services and the Department of Human Services said: 'Our departments are working together closely to bring on more workers to process applications and redeterminations, as well as training and technical experts to support front-line staff.'"

The written statement was not available to answer questions.

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"According to state data, the Medicaid backlog rose steadily through 2017, reaching a critical point that October, when the state began using a new computer system to process applications, according to Carrie Chapman, director of advocacy for the Legal Council for Health Justice. The new computer system had problems with new applications and so-called redeterminations. In some cases, people who were still eligible were cut off during the yearly renewal process and had to reapply, Chapman said."

This happened to me last July, and again last December.

"She said another factor has been the 'diminished workforce' to deal with the Medicaid backlog. With Illinois facing chronic budget problems, the human services agency lost staff under former Govs. Bruce Rauner and Pat Quinn, which made it harder to deal with the backlog, according to Chapman."

But the backlog was still there. I suspect it always has been.

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As longtime readers may recall, I've been on Medicaid since it was expanded in Illinois and other willing states under the Affordable Care Act to include income criteria alone, apart from having children or a disability. And as longtime readers may recall, it's been royally fucked-up in Illinois since Day One.

I've been up, down and sideways through the Illinois bureaucracy for years in a never-ending battle to obtain, use, maintain and reacquire health care through Medicaid, which by the way is where the federal marketplace sends me if I attempt to just go buy it myself like everyone else - something that is astonishingly unaffordable.

That also means I've had to go without health care for periods of time due to bureaucratic bungling, and I've at times survived only because of a private stash of back-up meds supplied by a doctor's closet of samples. Once on an active plan, there is then the health care company itself to deal with, in addition to the state. It's quite lovely.

Finding a competent Medicaid doctor is the next step. I still haven't advanced to that one, in fact. Looking again now. And so on. And I'm one of the lucky ones - I don't have it nearly as bad as many others, I'm sure, who are in advanced stages of illness or don't speak English or have little skill and experience negotiating bureaucracies. Think Comcast on bureaucratic steroids and you've got Illinois Medicaid.

Am I biased, then, because I have a personal stake in this story? Only in the sense that I have a far deeper insight into the realities of what's been going on for years, and the particular fault lines, than most reporters. After all, reporters bring their own experiences to the job every day - changes in their property taxes, their neighborhoods, the tax that "suddenly" shows up on their pop and the outrage they feel at it. In this case, hundreds of thousands of Illinoisans have been suffering for years not because government is incompetent but because government doesn't care. And by government, I mean the people and politicians of Illinois. Get your hands off of my stack, Jack!

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Also, guess what? I've been covering this stuff since well before I was on Medicaid myself. Let's take a trip through the Beachwood vault for a fuller measure of the problem.

March 30, 2007: "Chief human-resources executive, M. Susan Chambers . . . noted [in a memo] that forty-six per cent of the children of Wal-Mart's million-plus American employees were uninsured or on Medicaid."

A reminder both of just how many recipients are indeed employed, as well as how much the private sector stresses the public sector - and then complains about what they wrought, as if they had nothing to do with it.

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March 19, 2010: Medicaid is a bipartisan failure.

"Obama did, however, incorporate the wackiest notion to come up at the summit into his proposal. When Tom Coburn (R-Oklahoma) whined and pleaded for sending undercover agents into hospitals to weed out Medicaid fraud, I thought the summit would be deemed a success for the way the president let the nutballs expose themselves. Guess not."

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February 17, 2011: "Quinn said Illinois must achieve 'financial stability' and proposed cutting aid to poor seniors, eliminating a prescription drug discount program and reducing spending on social services like alcohol and substance abuse treatment. He also called for reining in costs of Medicaid programs that cover health care for the poor."

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May 8, 2012: "Sen. Kirk Dillard, R-Hinsdale, has argued for years that much of Illinois' Medicaid problem could be solved by rooting out waste and abuse," AP reports. "He says experts believe 10 percent of Medicaid money is spent improperly, which would amount to nearly $1.5 billion in Illinois. Unfortunately, there's little evidence to support that claim."

There never is - unless you put a dollar figure on how often pols make inflated claims of the amount of waste and abuse in programs such as Medicaid.

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June 20, 2012: "The Quinn administration is gearing up to hire a company to check the eligibility of Medicaid patients, a key part of a plan to cut $1.6 billion a year from the health insurance program for the poor," Crain's reports.

Also, neither the Quinn nor Emanuel administrations are hiring companies to check the eligibility of tax subsidy and TIF recipients. They already know most don't qualify.

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Feb. 25, 2013: "Savings from cuts to the Illinois Medicaid program have fallen short by $464 million, about 30 percent of the expected $1.6 billion in projected savings that Gov. Pat Quinn pushed for last year," AP reported last week.

"In the first public report on how cuts to the health care safety-net program are being carried out, Illinois Department of Healthcare and Family Services Director Julie Hamos detailed the actual savings of cost-cutting measures so far. Hamos reported to the House Human Services Appropriation Committee on Thursday in Springfield."

Present-day note: She's still around.

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Back to our regularly scheduled archive dive:

"Some cuts have gone as planned, such as dropping Medicaid coverage for thousands of working parents and eliminating coverage of dental care and visits to chiropractors for adults.

"We were able to achieve a billion dollars in health savings and that's never been done in Medicaid history," Hamos told The Associated Press in a telephone interview after giving the report.

Proud!

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April 10, 2014: Medicaid Drowning In Backlog: Illinois One Of The Worst States.

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June 15, 2014: Medicaid Applications Keep Piling Up In Illinois.

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Feb 9, 2015: Me and My Medicaid.

This is a must-read, folks!

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Including this favorite passage:

The redetermination folks, by the way, are a third party - yes, it was outsourced - who don't know what the hell they're doing. A customer rep there insisted to me that expanded Medicaid had nothing to do with Obamacare. After failing to reason with him, I called back and asked to speak to a supervisor. Guess who I was handed to? The same dude!

ME: So now you're a supervisor?

HIM: Yes.

ME: But when I talked to you a few minutes ago, you were just a customer service rep.

HIM: Yes.

ME: So if I had asked you to hand me to a supervisor, you would have handed the phone to yourself?

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He also insisted that one had to be elderly or disabled to qualify for Medicaid. I explained to him that one could qualify by income - and that the Obamacare expansion expanded the range to include more people, like me. He insisted this wasn't true. I read him a paragraph from the Illinois Department of Healthcare and Family Services.

HIM: Where are you reading that from?

ME: The Illinois Department of Healthcare and Family Services' website.

HIM: Well, anyone can put anything they want on a website.

That's Hall of Fame right there.

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July 17, 2017: Not Just For The Poor: The Crucial Role Of Medicaid In America's Health Care System.

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Thread.

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May 19, 2018: Thousands Illegally Denied Health Coverage In Illinois.

"Attorneys on behalf of thousands of low-income people filed a motion in court on Wednesday to enforce federal law and the State of Illinois' agreement to process Medicaid applications in a timely fashion. The attorneys charge that the State is violating both federal law and an Illinois court order by significantly delaying Medicaid applications and denying residents access to health coverage."

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Thread.

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Thread.

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Yes, let's.

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March 4, 2019: Me And My Medicaid Again.

"I'd think about going to the doctor, but last Wednesday I got a letter from the state informing me that they were taking my Medicaid away two days later, last Friday. Thanks for the warning!

"Didn't I just go through this last July? Yes. Yes I did. I got my Medicaid restored then because it never should have been taken away. But that's what's been happening in Illinois, and elsewhere, for years, and to people in far worse shape than me.

"The funny thing is, my income - which was cited as suddenly being too high to be eligible for Medicaid - has not only not changed since I first qualified for Medicaid under the Obamacare expansion, but it has gone down. Nevertheless, they persist."

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March 11, 2019: It's Almost Like You Have No Experience In Business At All.

"Just got a call from someone at DHS reprocessing my case: 'I've been looking at the case notes for 30 minutes and none of it makes sense.'"

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New on the Beachwood . . .

TrackNotes: Heroic Derby Stewards Resist Trump's American Autocracy
Now do impeachment.

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CHIRP Record Fair Recap
A music collector's paradise.

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ChicagoReddit

Here's a digital painting I just finished centered on one of my favorite Chicago music venues - The Empty Bottle. Music friendly dancing in the year 2??85 from r/chicago

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ChicagoGram

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TweetWood
A sampling.

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Thread.

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The Beachwood McRibTipLine: Meaty.



Permalink

Posted on May 7, 2019


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