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The state's rejection of Health Alliance from its new menu of health plans for state employees has prompted the Urbana-based medical plan provider to mount a campaign in its own defense --- including the filing of a formal protest with the state.
Health Alliance officials note that they provide exclusive HMO coverage for several providers including Carle (Health Alliance and Carle Physicians Group are both owned by the Carle Foundation). Without a Health Alliance plan, state employees and retirees will have no access to those doctors under an HMO plan.
But the new health plans for state employees offer other plans that include Carle. They are open access plans --- three-tier plans that work like HMO's at their lowest tier, but offer more expensive access to more doctors at their 2nd and third tiers. Two open access plans from PersonalCare and HealthLink would offer access to Carle doctors at their 2nd tier.
Without giving specific numbers, PersonalCare CEO Todd Petersen says the price difference between Tier One and Tier Two is not a big one.
"There is a difference in deductible and co-payment," Petersen said. "They (the 2nd tier prices) would be a little bit higher. But it's still --- compared to the general market --- it would still be one of the richest benefits on the market today."
Petersen predicts that Carle and and other providers with exclusive contracts with Health Alliance will make arrangements with other health plans --- but not until after Health Alliance's formal protest is heard.
"But then, I do expect that the market will adjust to the new realities and you're likely to see providers participating in products that they have historically not participated in," Petersen said.
In the meantime, Petersen notes the bottom tier of PersonalCare's open access plan includes several central Illinois medical groups and hospitals, including Christie Clinic, Provena, Sara Bush Lincoln and hospitals in Gibson City and Decatur.
Although Illinois Sen. Mark Kirk says the details have not been revealed, he supports the agreement to cut federal spending that averted a government shutdown.
Democrats and Republicans in Congress, and the White House, announced Friday a deal that cuts $39 billion. Coupled with other actions earlier in the fiscal year, total spending is reduced by $78 billion.
U.S Senator and Assitant Senate Majority Leader Dick Durbin said "while these cuts will be painful, we must now turn our attention toward addressing our long-term debt and ensuring a future of fiscal responsibility."
In a statement released by his office, Durbin noted "the agreement is the largest budget cut in our nation's history, but still preserves the investments needed to help our economy continue to recover."
Speaking from Washington, Kirk said the parties on Friday also agreed to a budget for the full fiscal year, which ends Sept. 30. He said the agreement does not delve heavily into social issues, but is focused on spending.
Calling the process "overly dramatic,'' Kirk said with the agreement, Congress will return to its normal rhythm, and will begin dealing with next year's budget.
Digital technology and video games have a big impact on many kids' lives-and some believe they could play a bigger role in education. As Illinois Public Radio's Linda Lutton reports, Chicago is getting a new school that some think might be a window into the future of learning.
(Photo by Linda Lutton/IPR)
Illinois' Junior Senator remains optimistic that a deal will be struck just short of midnight and that Congress will avoid a government shutdown.
Republican Mark Kirk says in general, Democrats should give on spending proposals, and the GOP should give on 'extraneous' policy measures to avoid the shutdown.
"I think congressional negotiators typically work up to the last minute," said Kirk. "But my guess is because President Obama doesn't want a shutdown, Speaker (John) Boehner doesn't want a shutdown, and Senate Majority Leader (Harry) Reid doesn't want a shutdown, you have a succesful end to the negoations today."
Kirk says there was also discussion in the Senate late Friday about a short-term continuing resolution that could last as long as 4 days, that fully funds military troops.
During a separate conference call earlier, Democratic Senator Dick Durbin said a budget deal hinged on funding for Planned Parenthood. Kirk says the program shouldn't be singled out for a 100-percent cut, but rather a broad-based, shared sacrifice.
Senator Kirk also says he won't keep his congressional pay if the government, instead giving it to charity.
The HMO plans that the Quinn administration wants to offer to state employees starting in July only covers 27 Illinois counties.
Blue Cross/Blue Shield of Illinois' two HMO plans would serve the state's most populous counties, covering Chicago, Rockford, Springfield, Peoria and the Metro East. But the health plans have no health care providers signed up in most of east-central, southeast, southern and western Illinois would not be included.
Blue Cross spokesperson Mary Ann Schultz says in a press release that they're working to sign up more providers in other counties. In the meantime, she says state employees could use the other available plans. Those are the Quality Care preferred provider plan, which offers access, but a lower level of coverage; and two open access plans from HealthLink and PersonalCare. They offer HMO-level prices for physicians in their lowest tier, and higher prices if you want access to other doctors.
The state Department of Healthcare and Family Services says the new plans will save the state over $100 million a year. But State Representative Chapin Rose says the state's research erroneously projects Blue Cross' lower operating costs in urban areas onto the state of Illinois as a whole.
Rose's Illinois House district stretches from Charleston to Champaign, one of the areas not covered by the Blue Cross HMO plans. The Mahomet Republican says the alternatives have their flaws, too. He predicts how those in his region would use the new health plans.
"You have a bunch of people that either migrate on to (the) QualityCare plan, which will be incredibly expensive to the state taxpayers," Rose said. "Or they will dump into PersonalCare, and go to Christie Clinic. The problem is, Christie Clinic does not have the capacity to suddenly have 55-thousand people at its doors. Just can't do it."
Rose says many of those seeking care from Champaign-based Christie Clinic will be former patients of Urbana-based Carle. Health Alliance, which has an exclusive HMO arrangement with Carle, was turned down in the bidding for the new health plans. The open access plans would offer Carle at its more expensive tiers, and Christie Clinic at the lower-priced tier.
Health Alliance is filing a formal protest against the new health plans, and Rep. Rose says that should make documentation available that he believes will show the flaws in the health plan selection process. In the meantime, a legislative commission will review the plans on Monday, April 11th. The meeting of the Illinois Commission on Government Forecasting and Accountability is set for 10 AM at the Illinois State Capitol Building in Springfield. Rose says he's worried that the commission will vote to approve the plans before those documents are available.
The lawmaker says the best course of action would be for the commission to take its time on the matter. But he argues that an even better course would be for the Quinn administration to withdraw the health plans, and start over.
Criticism and confusion continues with the Quinn administration's proposed health plans for state employees and retirees in the next fiscal year.
The proposal would remove Urbana-based Health Alliance from the mix, raising difficulties for patients who use doctors at Carle, Springfield Clinic and McDonough District Hospital in Macomb. Those hospitals and clinics have exclusive HMO contracts with Health Alliance (a Carle subsidiary).
Instead, HMO coverage for state employees would only be offered by Blue Cross/Blue Shield of Illinois which has no primary care physicians under HMO contracts in the Champaign County area. A spokesman for BCBS says they do not have HMO providers in every county.
But a spokesman for the Illinois Department of Healthcare and Family Services says there are other options in their proposals --- namely the open access plans offered by HealthLink and PersonalCare. Mike Claffey says those plans offer medical coverage at different levels. He says Tier 1, the least expensive, works like an HMO. Claffey says it's his understanding that Champaign-based Christie Clinic is part of the provider network at Tier 1 levels in the open access plans, while Urbana-based Carle is available at the more expensive Tier 2 and Tier 3.
State Representative Chapin Rose says the proposed health plan lineup goes before a legislative advisory panel in Springfield on Monday. And Rose says he thinks the Commission on Government Forecasting and Accountability is predisposed to approve the proposal. The east central Illinois Republican says the commission needs more accurate numbers on the new health plans --- numbers he says won't be available until after Health Alliance files its formal protest.
"Filing their protest is what gives them the cost document they need to officially disprove these cost issues," Rose said. "If the (commission) votes on Monday, they will be voting without the actual real numbers to prove or disprove what's going on."
Meanwhile, an organizer with Champaign County Health Care Consumers is urging state employees not to panic. Anne Gargano Ahmed says if the state's decision is approved, it should give Carle the incentive to negotiate with Blue Cross Blue Shield for HMO coverage.
A weather forecaster says he may have to live off the money he's been setting aside for a Caribbean vacation. A worker in Washington hopes to polish his resume so he can retire from public service and work in the private sector. An accountant wonders if she can put off her mortgage for a month.
Federal workers like them across the U.S. will be out of work and without a paycheck if the looming government shutdown isn't averted. Some say they will make the best of it, using the spare time to get a few things done. Others are far more fearful of how they'll provide for their families.
The partial shutdown, which could start at midnight Friday, leaves workers with many questions - some serious, others more mundane: How long, if at all, will they be away from their jobs? Who will be deemed "essential" and be told to come to work? Should I cancel the kids' daycare? Will I still be able to afford that pre-planned vacation?
About 800,000 federal government workers would be affected by a shutdown.
The ripple effects stretched far beyond the Washington metro area, where so many federal employees work and live, to places like Chicago, where more than 100 people facing no paychecks protested outside a federal building with signs, "Don't Punish the Public" and "Banks got bailed out, we got sold out."
National parks would close, and the IRS would not process paper tax returns. But the nation's federal prisons would remain open and air traffic controllers would report to work, as would federal inspectors who enforce safety rules.
In Little Rock, Ark., National Weather Service meteorologist Dan Koch said he worries about how a shutdown could affect his family, including his two children. He said he'd still report to work for business as usual - but he wouldn't get a paycheck until the shutdown ended. He's putting more into savings to prepare, he said.
"I was actually saving up for a Caribbean cruise, but that money may actually be used to live on. It's certainly more important to make sure we can get the bills paid and provide for our family," he said.
Others saw opportunity.
John Haines, 64, has worked for the federal government more than 35 years. His duties as deputy director of the office of community renewal at the Department of Housing and Urban Development keep him busy all day long - leaving him little time to prepare for his transition to a new job in the private sector. He said he's been meaning to update his resume for some time.
"I guarantee you if I'm not coming to work Monday morning that I'll have more energy to do the kind of work that I should have done already" to prepare for the future, he said.
Haines wasn't even sure if he could count on a three-day weekend. He was headed to a seminar this weekend in North Carolina and hoped to visit a son there who serves in the National Guard, but he didn't want to miss work Monday if his office was open.
"So I'm not doing any planning beyond the immediate future," he said.
In Salt Lake City, home to about 12,300 federal employees, Leslie Steffs was applying for new hospital positions. The 55-year-old single mother, an administrative assistant assigned to the downtown Wallace F. Bennett Federal Building, said she was concerned about making mortgage payments.
"Some people say we'll just have to tough it out, but I have a family to support. This is no joke," Steffs said.
That was echoed by Justin Castro, a park service worker at the Oklahoma City Bombing National Memorial.
"Not having a check means not paying rent and not paying bills that need to be paid," he said.
A sheriff on the eastern end of Rocky Mountain National Park is encouraging people to still visit. Larimer County Sheriff Justin Smith said he'll provide emergency services and law enforcement to visitors on the eastern side of the park within his county in the event of a shutdown.
He said merchants in nearby Estes Park whose business would be hurt by a lack of visitors shouldn't be pawns in Congress' budgetary battle.
However, Patrick O'Driscoll, a spokesman at the National Park Service's regional office in suburban Denver, said Smith's department has no jurisdiction and the park will be closed if there's a shutdown.
Limitations would not just affect the states. Aaron Tarver, a spokesman at the U.S. Embassy in Seoul, South Korea, said U.S. citizens will still have consular services if needed but passports would be limited to emergencies. In the Philippines, the U.S. Embassy in Manila would only provide limited and emergency services if a shutdown happened, spokeswoman Rebecca Thompson said.
In Chicago, one of the demonstrators was Julie Sidlo, an Environmental Protection Agency accountant who endured the last government shutdown in the 1990s. This time, she doesn't know how her job would be affected but is preparing for the worst, she said.
"I've sent an email to my mortgage company asking if I can delay payment for the next month, and gotten no response. I don't know if I can file for unemployment," Sidlo said, adding that she's set money aside for several weeks. "I've decided not to make any purchases I don't need to. I don't go to restaurants."
The government continued lurching toward a shutdown even as Congress continued negotiations to avert it and leaders expressed hope they could get a deal done. House Republicans advanced a stopgap measure Thursday that would keep the government running for another week, cut $12 billion in domestic spending and fund the Pentagon for six months. But President Barack Obama threatened to veto the bill even before it passed, and Senate Democrats showed no willingness to allow a vote on it.
Haines, who joined HUD in 1979 and before that worked for the Department of Transportation, said attrition at his workplace had pushed him to more rigorous hours. Though retirement-eligible, he's now considering private sector jobs in economic development and said the threat of a shutdown laid bare what he said was a depressing change in the way the public values government workers.
"The advantage of being a federal employee is, supposedly, job stability. You sacrifice your total pay for whatever the job satisfaction and a high degree of job security," Haines said. "That's the tradeoff, supposedly - and, supposedly, good benefits."
On Thursday, though, he wasn't so sure of that.
The event of a government shutdown late Friday night means most of 15th District Congressman Tim Johnson's staff will be temporarily out of a job.
Fourteen workers in all would be laid off, and spokesman Phil Bloomer says he and three other staffers, including Chief of Staff Mark Shelden would remain on the job, but unpaid. Bloomer adds that there are a lot of other concerns regarding his office's daily dealings with the public.
"Our staff performs real vital services in terms of visas and passports, and helping people with their social security programs," Bloomer said. "We got dozens and dozens of other cases with the VA and social security, and otherwise."
Bloomer says he is still cautiously optimistic that an agreement will be reached by Congress tonight. He blames Congressional Democrats and those in the White House for 'dithering around' for months and allowing things to get to this crisis point.
Names of people authorized to own guns would be declared secret under legislation approved by the Illinois House.
The state police would be barred from releasing information on people who have Firearm Owner Identification cards.
The House approved the bill 98-12 Friday. It now heads to the Senate.
The attorney general ruled last month that the list of people with FOID cards must be released under the state Freedom of Information Act.
Firearm advocates objected. They argue the information would tell criminals who owns guns that are worth stealing.
The bill would allow disclosure of names in criminal investigations.
With a government shutdown looming at midnight Friday night, all U.S. House Republicans from Illinois voted Thursday to fund the government for at least a week. The state's Democrats all voted against the bill.
Republican U.S. Rep. Robert Dold from the North Shore voted for the stopgap spending bill, which he says proves his party wants to avoid a shutdown.
"What we're doing right now is doing all we can to make sure we keep this budget - or the continuing resolution going so we can keep the government up and functioning for the American public," Dold said in an interview following the vote.
The bill would also fund the military through the end of the fiscal year.
The president has promised he would veto that measure, his staff pointing out it contains some $12 billion dollars in non-negotiated cuts.
Evanston Democrat Jan Schakowsky said Thursday that the onus is on Republicans to agree to a final deal.
"We have agreed to a number of pretty painful things. I'm not thrilled about what we've agreed to," Schakowsky said. "But they keep moving the goal posts, and it's clear that they are pushing for a shutdown."
Federal employees deemed "essential" can work through a shutdown. Members of Congress get to decide which of their staff fit that description. Schakowsky said she believes all her staff are essential, while Dold said he would "pare down" his team.
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