The news from Springfield about the state of Medicaid in Illinois has been sobering. The system, which supports 2.7 million people and covers half of all births in Illinois, is grappling with $1.9 billion in unpaid Medicaid bills. The Civic Federation projects $21 billion in unpaid Medicaid bills by 2017 if the system is not restructured. (See Gov. Quinn's fact sheet on Medicaid for more information.)
Gov. Quinn's proposal, released this month, reduces Illinois’ Medicaid liability by $2.7 billion, with three-quarters of the plan comprised of cuts, reductions and efficiencies, one-eighth in state revenue, and one-eighth in federal matching funds:
- Cuts, reductions and efficiencies to 58 separate items totaling $1.35 billion (50 percent)
- Rate reduction to providers totaling $675 million – (25 percent)
- Additional revenue through a $1 per pack increase in the cigarette tax totaling $337.5 million (12.5 percent)
- 100 percent federal match funding from the increased cigarette tax totaling $337.5 million (12.5 percent)
(See the governor's press release on the proposed Medicaid restructuring.)
The Chicago Tribune has covered how cuts and reductions will affect those who depend on the system for health care. (See "Medicaid spending cuts loom," "Quinn wants deep cuts.")
Chicago Dental Society has expressed its concern about preserving access to dental care among Medicaid patients; yesterday Illinois State Dental Society issued the following press release on the penny-wise, pound foolish proposal to cut adult dental programs from Medicaid:
Cutting Adult Dental Program for Medicaid a Proven Disaster
The Illinois State Dental Society recognizes that Governor Quinn and the Illinois legislature are facing intense budget pressures as they attempt to find $2.7 billion in savings from the Medicaid program. However, eliminating the adult dental program from the Medicaid budget will not produce any significant savings. Adults that experience pain and infection from dental conditions will be forced to seek treatment in hospital emergency rooms, where staff is unable to provide definitive treatment and costs to the Medicaid program skyrocket. In a dental office, an emergency exam and surgical extraction of a tooth would cost the dental Medicaid program $73.60, and could address the condition before it escalates into multiple emergency room visits and possible hospitalization. Dental problems will not resolve themselves, and in some cases, patients will develop severe systemic infections that require hundreds of thousands of dollars in hospitalizations. Retaining the adult program is the only cost effective and efficient option for treating dental problems.
Gov. Quinn has also proposed a reduction in Medicaid reimbursement rates for healthcare providers in an attempt to achieve even more savings. Additional rate cuts to the dentists who provide care to children covered by the Medicaid program would be devastating. For decades, Illinois has reimbursed dentists for restorative services, like fillings and crowns, at levels drastically below the costs of providing care. Illinois ranks 48th in the country for its Medicaid funding rates. Further cuts will drive even more dentists away from treating the children's Medicaid population.
The State of Illinois learned an expensive lesson about cutting adult Medicaid dental services when former Gov. Edgar took that action in FY 1996. By the next fiscal year, the adult program was restored. Let’s not repeat a past history of failure. The Illinois State Dental Society encourages a thorough review of those currently eligible to obtain services under the Medicaid program to ensure that scarce state funds are truly being used for the most vulnerable populations. The dentists of the Illinois State Dental Society will continue to work with Governor Quinn and the Illinois legislature to develop an appropriate solution that will not harm patients or falsely claim short-term savings.