State Workers’ Health Insurance Claims at Risk in Illinois
By - Currently, there is a healthcare coverage crisis taking place for state employees in Illinois. CBS reports that the state of Illinois is having major complications related to keeping its budget intact. The state budget issues are impacting health insurance claims of many government employees as well as the healthcare providers who treat these individuals.
Health insurance claims are likely to be left unpaid for those who are covered under the state’s insurance programs, according to CBS. Workers who get their health coverage through Illinois are likely to have a severe financial impact if they end up needing emergency care.
The Illinois Department of Central Management Services stated last month that the state is no longer able to pay medical or dental claims among hospitals and medical facilities providing services to self-insured individuals. The list of the people this affects includes university employees, government workers, and family dependents.
As such, this impacts the health coverage of approximately 150,000 people across Illinois. Without a working state budget, it makes it impossible to cover the health insurance claims of many working government employees.
A spokesperson for Central Management Services had told the source that the state was able to pay claims until this point in time because the agency was covering the costs of last year’s claims. Now that they’ve moved onto this year’s claims processing, the funds to cover various healthcare services are nonexistent.
“That’s where the concern is gravest that providers could ask employees or retirees to pay cash up front for their healthcare,” Anders Lindall, AFSCME spokesperson, told the news source. “We’re in uncharted waters.”
More consequences of the budget fiasco is expected to occur throughout Illinois as time goes on. Last month, State Comptroller Leslie Munger warned citizens of some more potential outcomes.
However, officials from the Centers for Medicare & Medicaid Services (CMS) have stated that government employee’s insurance plans will still be viable and the workers will be reimbursed once a budget is put into place within the state of Illinois.
Spokesperson Anders Lindall claims that the budget problem lies square on the shoulders of Governor Bruce Rauner because the official did not use his line item veto power last summer to prevent these financial issues.
However, those representing Governor Bruce Rauner have stated that the blame rests on the state legislature for not being able to pass a balanced budget. A spokesperson from CMS has also stated that fully insured state government employees and those with HMOs are not affected by the budget issues in Illinois for the time being.
These kind of health insurance claims management problems are not acceptable in a first world country. Individuals who participate in self-insured plans should be able to receive much-need healthcare services without having to pay all of the costs out-of-pocket.
“Some people need to see their doctors. Some people have standing prescription drugs that they need for their livelihood, so this is not something that you can make a choice whether I can go to the doctor or not, whether or not I take my prescription drugs, whether or not I go to my physical therapy. This is a life and death situation,” Democratic State Representative Mary Flowers told the Illinois News Network.
