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updated: 4/22/2013 4:54 PM

State's bill backlog could grow if Medicaid expands

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Associated Press

SPRINGFIELD -- An expansion of Medicaid under President Barack Obama's health care overhaul could increase Illinois' existing backlog of overdue bills and result in even longer payment delays to the state's service providers, according to a health care expert.

The (Springfield) State Journal-Register reported Monday that starting in 2014, an estimated 342,000 uninsured Illinois residents would be newly eligible for coverage if lawmakers approve expansion of the health care program for the poor and disabled.

A critic of the expansion plan, which would be fully subsidized by the federal government for the first three years, said it would mean an even longer payback period for the state's $9 billion backlog of past-due bills.

"Before you go expanding and taking on additional liability you need to make sure that the people who are already on the rolls are taken care of, and that's not what's happening," said Pat Comstock, executive director of the Health Care Council of Illinois.

Under Obama's Affordable Care Act, which aims to provide health insurance for everyone, Medicaid would be expanded to reach more people. The federal government would pay for the state expansion in full for the first three years, and then 90 percent of it until 2020.

The Illinois Senate in February approved a measure authorizing expansion. Officials expect the House to vote on the issue before the Legislature's scheduled May 31st adjournment.

The expansion sponsor, Chicago Democratic Sen. Heather Steans, said the short-term influx of federal cash could reduce the state's payment delays. But she acknowledged that in the long run, payment delays could increase with, among other things, people who are eligible for Medicaid right now but aren't using it, but will sign up for expansion as the program is publicized.

Expansion also comes just a year after a major cost-cutting reduction of Medicaid services, which Democratic Gov. Pat Quinn trumpeted as a state savings of more than $1 billion. Comstock says the administration is about $500 million short of reaching its $1.6 billion goal.

If lawmakers OK expansion, the state would receive nearly $5 billion in federal funds for Medicaid expenses in 2014, 2015 and 2016. The state's annual cost after that, through 2020, would be $573 million.

Recent income-tax payments brought the state's backlog of late bills to $7.6 billion. But the comptroller's office estimates the amount will rise late in the year and total $9 billion, of which $2.5 billion will be owed for Medicaid.

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