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State Lawmakers Confused, Skeptical on DCFS Medicaid Transition Plan

Illinois' Department of Children and Family Services plans to put all 16,000 children in its custody on Medicaid health insurance. But at a hearing Tuesday, state lawmakers expressed skepticism, saying they’re worried those kids may fall through the cracks.

If you’ve ever moved from one insurance plan to another, you know it can be complicated. Now try doing that for thousands of foster care children at once.

That’s what DCFS, alongside the state's Department of Healthcare and Family Services, is trying to manage for all the kids who are considered wards of the state. It wants to move them all to Illinois’ Medicaid plan, known as IlliniCare.

But people like State Rep. Mary Flowers (D, Chicago) say that plan is not soup yet.

“The road to hell was paved with good intentions, and I’m sure you have that," she told a panel of healthcare officials at the hearing in Chicago. "But you are experimenting with my children's lives, and I’m sick of it.“

According to the DCFS website, IlliniCare offers a kind of insurance known as "managed care." It's a familiar subject for those close to Illinois' Medicaid program; the state has been moving adult users to that kind of insurance over the past few years as a way to cut down on the costs wrought by expensive hospital visits and prescription drugs.

Though adults on Medicaid are using that kind of insurance now, Rep. Celina Villanueva (D, Chicago) says both DCFS and HFS are missing an important step in planning to use it with kids.

“It’s wonderful that you’re talking to each other, but are you talking to the children in care and what they specifically need?" she asked. "Is that an ongoing thing and an ongoing meeting that you’re having? Because if that’s not, then you’re already behind the game.”

It's unclear if DCFS has gotten public feedback on its plan, but the agency told lawmakers they’ve consulted with people who have graduated from foster care programs regarding the planned Medicaid move. IlliniCare admitted it stands to turn a profit if it adds DCFS children to its rolls.

Nonetheless, the department stated it's working to "ensure youth’s needs are prioritized"

Rep. Jennifer Gong-Gershowitz said she's worried kids who use IlliniCare exclusively may have fewer places they can go to receive care.

"If [a] provider is not a part of IlliniCare...then is it ultimately up to IlliniCare to decide whether or not that child continues to receive those services?" she asked. "It seems to be little bit self-serving."

IlliniCare's president and CEO, Leslie Naamon, told lawmakers it's already making special arrangements with doctors and others to get kids the healthcare they need. The company is seeking to add more providers to its coverage network.

"The idea is to build on the system, not to replace the system...that's really our goal. We are totally committed to that," she said.

DCFS is planning to move the kids in its care to Medicaid by November 1.

Meanwhile, IlliniCare itself is holding a series of public meetings on the transition plan before then. More info on when and where can be found here.

Sam is a Public Affairs Reporting intern for spring 2018, working out the NPR Illinois Statehouse bureau.
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