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Friday, March 25, 2011

Gov. Pat Quinn Gives Illinois Health Care Reform a Big, Fat Push Forward

In 2010, the Wisconsin Legislative Fiscal Bureau estimated that President Barack Obama's new health reform would save the state budget $365 million over the next five years.

In 2011, newly-inaugurated Tea Party Governor Scott Walker, despite a gaping budget deficit, ordered the state Attorney General to add Wisconsin to list of states suing in federal court to overturn the new health insurance law.

And so it goes with our northern neighbor, whose governor is giving the term "crank" a good name by comparison.

In Illinois, however, on the one-year anniversary of the new federal health law, Governor Pat Quinn has been blazing forward to implement its provisions. In fact, since taking office, Quinn has been on tear to reform Illinois health care more broadly.

Since March 23, 2010, the federal government has awarded $89.4 million in health reform funding to Illinois, and the law has delivered to 151,922 Illinois Medicare beneficiaries a one-time, tax-free $250 rebate to help pay for prescriptions in the "donut hole" coverage gap. In 2011, they will receive a 50% discount for covered brand-name prescriptions in the hole.

By August 20, 2010 Quinn had opened enrollment for the Illinois Pre-Existing Condition Insurance Plan to provide transitional coverage until 2014 for 5,000 Illinois residents who are currently uninsured with pre-existing conditions. So, far 2,000 individuals have filed applications and 943 have secured coverage.

One of those is David Zoltan, 33, of Chicago.

"As a diabetic of 25 years, I can breathe easier for the first time since I lost my insurance two years ago," said Zoltan.

Between 500,000 and 800,000 individuals will be covered under the state's Medicaid program with full federal funding. An additional 200,000 to 300,000 people will purchase their insurance through the health insurance exchange, with premiums subsidized by the federal government.

To fully implement the law here, Quinn's Health Care Reform Implementation Council, which held five public hearings since the governor established the panel on July 30, 2010, rolled out its first set of recommendations a few weeks ago on March 2, 2011, including calls for the state regulators be given the authority to approve or deny health insurance rate increases, and that insurance companies be required to spend at least 80% of premiums on health care for policy-holders. Those steps will require legislative approval.

"Governor Quinn has directed the state agencies that will play a role in implementing health care reform to work together to deliver on the promise of the Affordable Care Act," said Michael Gelder, chair of the council and Governor Quinn's senior health policy adviser.

In addition to the federal health reform, Quinn has acted on multiple other fronts to reshape Illinois health care, including electronic health records, Medicaid reform, private managed care, and chronic disease management, to name several.

On July 27, 2010, Quinn signed legislation, House Bill 6441, that will allow health care providers and insurers to share health records electronically. The law will provide providers with a secure system to access a patient's comprehensive medical history, avoid duplicate tests and procedures, and assure the accuracy of prescription drugs and other medical orders.

Medical information sharing is already saving Illinois big money. The state's medical home program, which centralizes patient information around one home base and one primary care provider, saved the state $220 million over 2008 and 2009, according to a recent study from the Robert Graham Center.

On January 25, 2011, Quinn overhauled the state's Medicaid program by signing a new law, House Bill 5420, which aims to expand coordinated care in Illinois, improving the efficiency of the prescription drug program, tightening the integrity of the eligibility process and increasing civil penalties for recipients who abuse the system. The reforms are expected to save $774 million over five years.

Quinn has also launched a private managed care pilot project for approximately 38,000 seniors and disabled Medicaid beneficiaries from Northeastern Illinois. The new program will save the state an estimated $200 million over the next five years, according to Quinn Administration estimates.

"We embarked on this initiative -- which was recommended by the Taxpayer Action Board -- to increase government efficiency and improve care for seniors and persons with disabilities," said Quinn.

And on January 25, 2011, Quinn approved another measure, House Bill 1444, that created the Chronic Disease Nutrition and Outcomes Advisory Commission. This panel, once the governor makes the appointments, will advise the Illinois Department of Public Health on how to incorporate nutrition as a chronic disease management strategy into state health policy, aiming to avoid costly Medicaid hospitalizations and to measure health care outcomes.

The commission, the brainchild of Deborah Hinde, the president and CEO of Chicago-based non-profit Vital Bridges that provides food and nutrition counseling to individuals with HIV/AIDS, will aim to develop a state nutrition strategy in chronic disease management, particularly for Medicaid-insured patients, given the treatment of chronic disease represents 80¢ of every dollar spent on health care.

"Medically appropriate nutrition can slow chronic disease progression, avert disability, minimize intensive health care utilization, and decrease costs to the state," said Hinde. "Because a state nutrition strategy can drive down Medicaid costs and improve health out comes, Governor Quinn was wise and forward-looking to sign this bill."

Meanwhile in Wisconsin, small business owner Martin Huennenkens, owner of Pilgrim Imports Inc., a Milwaukee wholesale company, is looking for Quinn-like gubernatorial wisdom on health care reform. "I feel like health care reform would at least give me a more level playing field," Huennenkens said. "I would love if the government would push more people in what I consider this good and correct direction."

Martin, Illinois is open for business.

David Ornsby
Public relations consultant and political strategist
(Originally posted in the Huffington Post Blog)

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