Medicaid reform must be part of budget solution

With Medicaid taking up an increasingly larger piece of the state's budget, spending for programs under its umbrella deserve utmost scrutiny.

Five years ago, education was the largest recipient of state General Revenue Funds, with Medicaid in second, representing about 24 percent to 25 percent of the pie.

Today, notes state Sen. Dale Righter, R-Mattoon, 31 percent of General Revenue Fund expenditures go to Medicaid, surpassing education as the biggest recipient of those funds.

In a meeting with the Pantagraph Editorial Board, Righter said the rate of growth in Medicaid funding is "unsustainable" and "runaway costs" must be reined in.

State Sen. Christine Radogno, R-Lemont, told the Editorial Board that the state can't get into a fiscally sound condition unless Medicaid is addressed.

They are both right.

Republican senators have proposed a package of bills that would help get Medicaid back on track -- not only to save the state money but also to ensure that those who need help through Medicaid will get that help.

If the state continues its current course -- programs expanded without concern for available funding and Medicaid providers being forced to wait months for payments that, in some cases, do not meet their costs -- it will be increasingly difficult for those on Medicaid to obtain quality care. Providers may drop out of the Medicaid program or even go out of business.

Twenty-four nursing homes have closed in the past five years, according to figures from the Illinois Health Facilities Planning Board. The closures were not necessarily a result of low reimbursement rates or delayed payments -- but that certainly didn't help.

In an editorial March 9, we expressed support for legislation that would phase out the practice of shoving payment of Medicaid bills into the following year's budget. The state should follow standard accounting procedures, promptly paying bills and charging them to the budget year in which the expense occurred.

Also deserving of passage is a proposal sponsored by Righter, Radogno and Sen. Carole Pankau, R-Itasca, to prohibit new or expanded Medicaid programs that don't have the express approval of the Legislature.

Likewise, it is common sense -- but unfortunately, not common practice in Illinois -- to require that applicants in the All Kids program meet the same requirements as other Medicaid participants to show proof of citizenship or legal immigrant status. This not only is fair, it improves the opportunity to obtain matching funds from the federal government, which requires such citizenship/immigrant status verification.