Illinois Public Media News
A measure that would scrap the new, controversial group health insurance plans for state employees, and restart the process under a different state agency --- with more legislative oversight - passed the Illinois Senate Friday evening by a 37-12 vote.
State Senator Mike Frerichs (D-Champaign) is sponsoring an amendment to Senate Bill #178, with downstate Republicans Dale Righter, Shane Cultra, Larry Bomke and Bill Brady signed up as co-sponsors. The measure cleared the Senate Local Government and Veterans' Affairs Committee on Thursday. Co-sponsor Righter said one problem with the new health insurance plans, is that they require many state employees now using HMO plans from Health Alliance and Humana to switch to Open Access Plans --- plans which the state self-insures.
"So the state's potential liability is going to go way up," Righter said. "Now again, that can save you money over the long term, as long as you run a tight, efficient program. That's really the question, I think, out there for lawmakers is --- is this administration in the habit of doing that, or is this administration even capable of doing that?"
The bill would go back to the present mix of group insurance plans, current set to expire at the end of June. The procurement process for new plans would start over --- but under the Department of Central Management Services --- not the Department of Healthcare and Family Services, which is presently in charge.
And Frerichs, the bill's lead sponsor, said the measure would give the General Assembly more oversight of the process for selecting insurance plans, through its Commission on Government Forecasting and Accountability.
"I think it's a good idea to have more eyes overseeing the process", said Frerichs, whose Senate District includes thousands of University of Illinois employees, many of whom receive healthcare through Urbana-based Health Alliance. "No one is perfect. People make mistakes. And that's why I've also focused on making sure that the General Assembly is involved in this as well."
Currently, the Department of Healthcare and Family Services is ignoring a vote by the Forecasting and Accountability Commission to block the new insurance plans.
The bill must now pass the House to beat the legislature's May 31st adjournment deadline.
A state agency's plans to proceed with new health insurance contracts means a number of calls have come in to the University of Illinois' Payroll and Benefits office.
On Wednesday, Illinois' Department of Healthcare and Family Services opted to proceed with a contract that leaves out Health Alliance and Humana HMO's.
Executive Director of U of I Payroll and Benefits Jim Davito says his office is taking questions from state workers in areas with no HMO coverage now asked to choose between Personal Care and HealthLink Open Access Plans, and the state's own Quality Care Health Plan. DaVito says concerns have ranged from higher cost to changing doctors.
He encourages state employees and retirees to thoroughly research their plans, and not have one chosen for them if they miss the June 17th deadline.
"We would much rather see each of our employees choose the new plan that they're going to have starting July 1, rather than having a default option defined by CMS (the State Department of Central Management Services) determine what coverage you're going to have for the next year," said Davito, who says the pending changes for state workers should prompt them to thoroughly review their benefits package. He says the same for some who have been on HealthLink the past few years.
"Many people have chosen it, but a lot of people have never looked at it," said Davito. "And so it's a new concept, and I would encourage people to look at the literature, and call HealthLink, and call Personal Care OAP, and talk about the questions that you have."
Davito says the Open Access Plans are unusual in that they're composed of three tiers, with the lowest tier being similar to an HMO. The state agency is moving forward with the state insurance contract despite a vote against it Wednesday by the legislative Commission on Government Forecasting and Accountability.
The U of I plans to hold more Benefits Choice informational sessions on campus soon.
(With additional reporting from Illinois Public Radio)
The state agency in charge of health insurance for public employees says it is going forward with a plan to drop Health Alliance HMO and Humana as options for state and university employees' medical insurance.
Urbana-based Health Alliance and Humana have protested the move.
The state's decision comes in spite of a vote Wednesday morning by the bipartisan Commission on Governmental Forecasting and Accountability (CGFA) to end self-insured/Open Access Plans for state employees, which is what the state planned to move employees to in areas where the HMO/Blue Cross Blue Shield plan isn't available. The vote potentially sets up a constitutional clash over the fate of health insurance for about 100,000 state and university workers.
Moving many employees to this sort of plan is how Governor Pat Quinn's administration had been planning to save up to $100 million a year.
Attorney General Lisa Madigan issued a ruling last week stating that legislators don't have the power to interfere with specific contracts. However, despite Madigan's ruling, State Senator and CGFA member Mike Frerichs (D-Champaign) said the commission has the authority to weigh in on policy changes. He also noted that the commission's vote reflects a major policy shift in self-insurance at the state level.
"And that's something we have consent power over," Frerichs said. "We don't have the ability to consent to individual contracts, but this big policy shift we do. We rejected that, and I think that will necessitate rebidding of the whole package."
State Senator Matt Murphy (R-Palatine) also sits on the commission. He said the vote by CGFA was done as an attempt to get all parties back to the bargaining table.
"My hope is that everybody involved in this process, rather than rush into court and having lawsuits, can all sit down together and try and perhaps try and rebid it, come up with a different plan," Murphy said.
It is unclear if the commission's vote is binding, and could send matters into a tailspin. The Department of Healthcare and Family Services is going forward as if that vote was insignificant.
"We followed the letter of the law," DHFS spokeswoman Stacey Solano said. "Everything was done fairly, it was done ethically, so why would we reopen the bidding?"
Downstate legislators have been highly critical of the decision to drop Health Alliance. They have shown no signs of letting down.
Meanwhile, many of the employees and retirees with Health Alliance as medical insurance say they don't want a new provider because they fear they will be forced to switch doctors. They are also concerned they will pay more out of pocket on doctor's visits.
As it stands now, state employees have until June 17 to decide what provider they want for medical coverage. The state is also considering opening another enrollment period this fall.
A study out, known as the Illinois Youth Survey, shows fewer Illinois teens are smoking cigarettes and drinking large amounts of alcohol at once, but the survey says marijuana use appears to be steady.
Beth Welbes with the Center for Prevention Research and Development at the University of Illinois said nationally, marijuana use is going up. She said the state findings show more teens are downplaying the risks associated with smoking marijuana.
"The state rates and the state estimates are really valuable, especially for state policy makers because they can take a look and they can see where do we need to direct our resources in terms of substance abuse prevention and other health areas," Welbes said.
The survey also reported a drop in DUIs among high school seniors, and a decrease in the use of illicit drugs, like cocaine and methamphetamine.
Ethics Commission Upholds Decision to Drop Health Alliance HMO, Humana
There's disappointing news for state and university employees and retirees who had been holding out hope Illinois would continue to offer Health Alliance and Humana health insurance.
Searching for lost children and seniors may be a little easier under a plan state legislators sent to Governor Pat Quinn.
It's a small wristband and fastens just like a watch, but instead of telling the time, a small microchip inside acts like a GPS system. They are worn by people prone to wandering off like autistic children or someone with Alzheimer's.
Lawmakers voted to allow the device to patch in directly to 911, an exemption not many other private alarm companies enjoy. The wristband itself could call police when a person goes missing. Carol Stream Republican Senator John Millner said a single cop can find the missing person, rather having to activate a whole search squad.
"With this device here, its simply one call, one activation and we would be able to find that person swiftly, saving money, saving time," Millner said.
But Rockford Republican Dave Syverson voted against it. Only one business in the state, Murphysboro-based Care Trak, currently makes the devices.
"For one company we're setting up that they can go to 911 direct, but for burglaries, and for seniors, they still run through the private sector," Syverson said.
Syverson said if the state gives this company an exemption, other alarm systems will want the same perk.
State legislators continue to give state employees a venue to air their grievances about the potential loss of their health care plan.
Members of the Senate Insurance Committee met Monday, and heard from about a dozen university workers and state employees whose HMO is Urbana-based Health Alliance.
Officials with the Department of Health Care and Family Services decided in May to end Illinois' 30-year relationship with Health Alliance, saying it would award HMO contracts for the next fiscal year to Blue Cross Blue Shield, with Open Access Plan contracts to PersonalCare and HealthLink.
The state estimates the new contracts would save taxpayers over $100 million a year, and over one billion dollars over the next ten years.
"This decision to drop Health Alliance is about more than bureaucratic procedure, state contracts, or budget numbers," State Senator Mike Frerichs (D-Champaign) said. "It's about potentially disrupted care, loss of long-standing patient-doctor relationships, and lack of access to quality health care at an affordable cost for tens of thousands of people in downstate Illinois."
State Senator John Jones (R-Mount Vernon) made an ultimatum to Governor Pat Quinn and Illinois Department of Healthcare and Family Services Director Julie Hamos. Jones said he may hold off on voting for certain pieces of legislation until the Health Alliance controversy is solved.
"There's a lot of major legislation that needs to be passed in the next few days, including a budget. It's time that all of us said, 'Hey governor, and Director Hamos, if you want that done, you better take care of this first," he said.
Officials from from the University of Illinois, Health Alliance, and Humana testified before the committee. However, there were no representatives present from from the Governor's Office or the Department of Healthcare and Family Services.
Humana Illinois also had its contract dropped.
One of the biggest gripes has been the dearth of facts leading up to the state's decision.
"It's shocking the lack of transparency and information when you're talking about a topic like health insurance and the magnitude of the cost," Humana Illinois Dave Reynolds said.
But health department officials say they are just following the law.
"We've had to be very conservative in what we can tell the public, legislators and even the press so as to not violate the strict ethical rules in the process," Healthcare and Family Services spokeswoman Stacey Solano said.
Solano said as soon as there is a ruling by a state ethics commission on Health Alliance and Humana's objections, the administration will be able to explain its decision. She said that should put to rest employees' fears and anxiety, which she said are "being fed by misinformation."
The Committee of Government Forecasting and Accountability (COGFA) is set to meet Wednesday, May 25 to discuss the matter.
Attorney General Lisa Madigan recently ruled it is not within lawmakers' power to approve or deny the contracts in question.
Many of the 100,000 state and university employees covered by Health Alliance HMO are outraged at the possibility they will have to switch plans and doctors and possibly pay more.
The Attorney General has issued an opinion that clarifies what legislators can do about it. Legislators continue to fight back against the decision to drop Health Alliance as an option for employee medical coverage.
The Attorney General's opinion says the legislature has no say over that. But the opinion does make clear a bipartisan legislative commission can authorize or reject if Illinois acts as a self-insurer.
The state has a self-funded, Open Access Plan now. Republican Representative Chad Hays of Catlin said employees will have no choice but to sign up for it because the new HMO choice, Blue Cross Blue Shield, doesn't have a downstate network of doctors.
"There simply is not an HMO option in most of downstate Illinois, so by definition we are going to push people into an open access plan," Hays said.
The commission could then say that with so many added people, it's unaffordable for the state to offer self-funded insurance, and reject offering one completely. That may send the issue into a tailspin, with potentially no managed care option, something the state must provide. It would pit legislators who want to keep Health Alliance, against Governor Pat Quinn. His administration says dropping Health Alliance will save the state money. The insurance firm disputes that claim.
The Department of Healthcare and Family Services says it's 100 percent confident in its decision and promises that will become clear once it allowed to release more details.
The state can't do that now because Urbana-based Health Alliance is protesting the bid process.
In the meantime Hays has filed a resolution asking that the state extend until September how long employees have to choose what health insurance they want for the next year.
Planned Parenthood of Indiana says it will continue serving Medicaid patients through at least May 30 after receiving more than $50,000 in recent donations from 44 states and overseas.
The organization said in a statement Thursday that it hopes to continue services beyond May 30.
It says donors are responding to a new Indiana law removing much of its public funding. It's earmarking the money for Pap tests, breast exams, testing for sexually transmitted diseases and other health care for 9,300 Medicaid patients at its 28 health centers across Indiana.
A federal judge has set a June 6 hearing on Planned Parenthood's request for an injunction blocking the new state law signed last week by Gov. Mitch Daniels. She has said she'll rule on the matter by July 1.
Carle Foundation Hospital has begun construction on a building that will focus primarily on heart and vascular care.
The nine-story Carle Heart and Vascular Institute, located on the hospital's campus, will include eight catheterization labs and upgrades to technology. The facility will also house intensive care beds that are currently located in buildings constructed in the 1960s and 1970s.
"We have a real need here to improve our facilities," Carle CEO James Leonard said. "We have fantastic technical capabilities. We have great people, but we're really out of space. The demand continues to increase for all cardiovascular care, both around heart attacks as well as strokes."
During a dedication ceremony Wednesday, the Institute's medical director, Matt Gibb, emphasized the center's role in treating health conditions that can worsen over time, such as a stroke, diabetes, or a heart attack.
"The tower will be a true environment for healing," Gibb said. "It will be a place where we can help patients prevent and beat heart disease, and also return to normal life following an event like a heart attack."
Hospital officials estimate the center will have a $100 million impact on the local economy, and create up to 150 jobs during the two years it takes to construct the building.
The $220 million project, which was approved by the state in 2010, will be financed with cash and the sale of bonds.
It is scheduled to be completed in 2013.
(Design courtesy of Carle Foundation Hospital)
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