State Medicaid Backlog Creates Delays, Frustration Locally

Tens of thousands of Illinois residents have been waiting beyond the 45-day limit for their Medicaid applications to be processed, the Chicago Sun-Times reports.

The backlog at the state level has caused many low-income people in central Illinois who might be eligible for Medicaid to forgo health care out of fear that they won’t be able to pay the bill, said Adani Sanchez, client services coordinator with the nonprofit Champaign County Health Care Consumers.

“Unfortunately, we’ve been on very long waits,” Sanchez said. “This is especially troubling when we’re trying to get people medication.”

Under federal law, the state has 45 days to determine Medicaid eligibility. A temporary card is issued if an application takes longer to process. But as of March 15, more than 112,000 people in the state had been waiting beyond the 45-day deadline, the Chicago Sun-Times reports. The state also failed to issue any temporary cards for people to receive benefits between June 2016 and September 2017, according to a lawsuit filed in U.S. District Court in Chicago last May.  

Sanchez, whose organization helps clients navigate various aspects of the health care system, says staffing cuts at Medicaid offices locally have made the backlog even more difficult to work around.

“Even at our local office, they have shifted the workflow a lot because of the reduction in staff and so people don’t really have a designated case worker anymore,” she said.

In addition to staffing cuts, the state’s computer system may also be partly to blame for the wait. There was a spike in delayed Medicaid applications in the state in October 2017, shortly after a new computer system was introduced to process them.

Sanchez said while the problem is occurring at different levels, it’s ultimately the patients who are suffering. “It’s the actual people who are forgoing care,” Sanchez said. “Who don’t have money to buy medication, and then the communities who have to try to support that in some way.”

State Sen. Heather Steans, D-Chicago, introduced SB2021 in the General Assembly in February to try to address the backlog problem. That legislation would cross reference data with information from other government agencies to determine Medicaid eligibility electronically in real-time. That legislation is still in committee.

About 2.7 million people in Illinois are currently enrolled in Medicaid or CHIP, according to the Kaiser Family Foundation.