SPRINGFIELD - Illinois Senate leaders have charged a few select lawmakers with reforming the state's Medicaid program and workers' compensation system - by Jan. 3.
But members of the bi-partisan commissions aren't scared off by the tall order due in a little over six weeks.
As co-chair of the Medicaid commission, state Sen. Dale Righter, R-Mattoon, said the topic has been simmering on the back burner long enough.
"This is an issue that's been discussed for years," said Righter. "There have been studies done on this, there's been research on this, there's been legislative proposal after legislative proposal on this."
As the state-federal health care program for the poor and disabled, Medicaid makes up a sizeable and growing portion of the state's annual budget. About 2.6 million Illinois residents are enrolled in the program, with an additional 700,000 expected to become eligible in 2014, when the federal health care reform law expands the program to include all residents making up to 133 percent of the federal poverty level.
Righter said the 2014 expansion just adds to the urgency for reform.
"So (let's) get our system in place and get it ready to try to absorb that - and I'm not sure we can anyway - but let's put our system in the best position possible to be able to deal with that," he said.
State officials have said new participants are expected to cost the state about $200 million annually. Although the federal government will initially pick up 100 percent of the costs of the new enrollees, its contribution will ratchet down to 90 percent after 2019.
Righter said implementing managed care in the Medicaid program - where a patient is assigned to a single doctor who acts as a gatekeeper for all health care, much like an HMO - must be on the table.
The state already has a start, albeit small. About 195,000 of Illinois' Medicaid patients are enrolled in voluntary managed care, and a pilot program set to begin next year will serve an estimated 40,000 elderly and disabled patients, according to an Illinois Department of Healthcare and Family Services spokesman.
Medicaid commission co-chair state Sen. Heather Steans, D-Chicago, also noted the state must move away from its institutional care of the elderly, mentally ill and developmentally disabled.
"We way over-institutionalize in Illinois compared to other states - very heavy costs associated with that, and we lose out on some Medicaid matching opportunities because of that," she said. "You can really reform the way we provide some of those service deliveries to get them in home and community-based settings (with) better health care outcomes and a much lower cost for the state."
Those lower Medicaid costs will contribute to an overall budget solution to Illinois' expected $15 billion budget deficit next year, Steans said.
"We need a real budget," she said. "I think this really is part of a comprehensive budget solution."
State Sen. Bill Haine, D-Alton, said workers' compensation reform is part of a solution to Illinois' business and manufacturing woes.
"Illinois is now, I believe, third in the nation in workers' compensation insurance costs to business and industry," said Haine, who is serving on the commission charged with reforming the system. "That simply cannot be sustained."
That's a drop from a ranking of 20th in the nation in 2006, according to a report issued by the state of Oregon, said Mark Denzler of the Illinois Manufacturers' Association.
Haine said the recent relocation of an Alton bullet manufacturer and its 1,000 jobs to Mississippi is rumored to be partly due to high workers' compensation insurance the manufacturer had to pay while in Illinois. But Illinois businesses don't have to look too far to find cheaper costs, he said.
"We have to face the fact that the surrounding states are very low in workers compensation costs - Missouri, Indiana, Iowa and Wisconsin," he said. "That's a problem for us, too."
But the problem with workers' compensation reform is the number of parties involved - employers, labor unions, doctors, hospitals, clinics, insurers - and the complex structure that awards settlements to injured employees.
But Denzler said he thinks the Senate effort is sincere.
"We believe Senate President Cullerton and Senate Minority Leader Radogno are very serious about addressing the cost of workers' compensation," he said.
But in six weeks?
"It's not what I'd hoped to do in December, but it's what I'm going to be doing," Haine said.