State leads Medicare reform: Pritzker

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By Dilpreet Raju
Capitol News Illinois
draju@capitolnewsillinois.com

Approximately 73% of Illinois’ Medicaid recipients remain on the rolls after the first redetermination cycle following the COVID-19 pandemic, while approximately 660,000 recipients have been disenrolled.

Speaking at a news conference in Chicago, governor JB Pritzker celebrated the fact that 2.6 million Illinoisans remained on the rolls despite redeterminations beginning anew, saying “this is what good government looks like.”

“I am proud to announce that Illinois is among the leading states in the country with a retention rate of 73 percent, one of the highest in the entire nation,” he said. “We made every effort to automate renewals, give customers more time and information, and to build the capacity necessary to manage the caseload and work to avoid letting people slip through the cracks.”

During the early stages of the COVID-19 pandemic, Congress enacted changes to Medicaid requiring states to keep patients continuously enrolled through the public health crisis, even if they might have become ineligible due to changes in their income or family circumstances.

That continuous enrollment program expired in March 2023, forcing states to resume the process of requiring Medicaid enrollees to reapply each year and determine if they were still eligible.

Federal officials estimated at the time that 17.4% of all the people enrolled in Medicaid and the Children’s Health Insurance Program would be disenrolled through redeterminations. That would have translated to about 15 million people nationwide, and 700,000 in Illinois.

The Department of Healthcare and Family Services said at the time it hoped to lessen the impact of the change and hold the number of people disenrolled to about 384,000.

But Monday, HFS reported more than 660,000 Illinoisans had been disenrolled from State health insurance in the past year. About two-thirds of those people lost coverage because of procedural reasons, like submitting incomplete information or not completing forms in time. The remaining were disenrolled due to finding new coverage, moving states or making too much money to be eligible for Medicaid.

A report by the national health nonprofit KFF, formerly the Kaiser Family Foundation, noted procedural disenrollment can be “concerning because many people who are disenrolled for these paperwork reasons may still be eligible for Medicaid coverage.”

Illinois had a high mark of nearly 4 million residents on Medicaid during fiscal year 2023, but redetermination effectively lowered the number of people on Illinois Medicaid down to pre-COVID levels.

Elizabeth Whitehorn, director of HFS, said reliance on publicly funded insurance grew due to the onset of COVID.

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