In Tony Cappasso's article in your Spotlight on Medicaid series ("Why costs have gone up," March, page 28), Ann Patia, the former director of the Illinois Department of Public Aid, makes an astounding assumption. She seems to imply that by cutting Medicaid payments to hospitals earlier this year, the department was able to "control Medicaid spending without hurting Medicaid patients." Does Ms. Patia really believe it is possible to neglect the institutions that provide essential medical and social services to Medicaid patients without hurting the patients themselves?
Since 1999, the number of Illinoisans covered by Medicaid and KidCare has grown nearly 10 percent. Fourteen thousand pregnant women who couldn't afford prenatal care in the past are getting it now through the KidCare program. In addition, more aged, blind and disabled Illinoisans are getting the help they need because lawmakers expanded the Medicaid program. Illinois hospitals applaud these expansions; they were the right thing to do. But instead of providing the funding hospitals need and deserve to care for more patients, Medicaid base inpatient payments to hospitals have been frozen for over eight years. To make matters worse, the state in January cut payments to hospitals by $30 million annually by imposing a charge cap that hits especially hard at hospitals that provide perinatal care for high-risk infants.
Unless the state pays hospitals fairly for caring for Medicaid and KidCare patients, hospitals face an unpalatable choice: limit care to the poor and uninsured in order to remain solvent, or continue to serve the entire community and risk bankruptcy and closure.
If more Illinoisans get health care coverage but the hospitals they depend on aren't there to serve them, what has really been gained?
Kenneth C. Robbins
President Illinois Hospital & Health
Systems Association
