By Jayette Bolinski, IllinoisWatchdog.org
Illinois’ children’s health insurance program spent thousands of dollars on people who were not eligible and didn’t investigate why children received multiple pairs of eyeglasses in a year, the latest audit of the program shows.
In addition, the All Kids program is not eligible for federal reimbursement, costing the state $85.7 million, an increase of $11.3 million from the previous year.
It all adds up to something the state can’t afford, one state lawmaker said Tuesday.
“Since instituted by former Gov. Rod Blagojevich and the General Assembly Democrats in 2005, the program has been riddled with not just bad policy, but with very poor management. There have been more than a few audits from the auditor general demonstrating that,” said state Sen. Dale Righter, R-Mattoon.
“This program has a history of wasting taxpayer dollars, and so I wouldn’t be shocked if there are problems.”
The audit, released Wednesday, focused on the expanded All Kids program, which is the non-Medicaid part of All Kids. It allows parents who do not qualify for Medicaid to obtain lower-premium health insurance for their children.
The expanded All Kids program serves children who were not previously covered by KidCare, the state’s original Medicaid program that provided health insurance for children in low-income families. The expansion includes children whose family income is greater than 200 percent of the federal poverty level or who were undocumented immigrants.
As of fiscal 2011, the year addressed in Wednesday’s audit, more than 97,000 children were enrolled in the expanded All Kids program. Total claims paid that year were $96.6 million, and the state received about $10.8 million in premiums. The whole All Kids program has 1.9 million enrollees, for whom the state paid $3.2 billion in claims.
Among the audit’s findings:
- A total of 414 people received medical services at a cost of more than $126,000 after their 19th birthday, when they were no longer eligible for coverage.
- A total of 315 people appeared to be enrolled with more than one identification number.
- All Kids incorrectly categorized 11,130 recipients as “undocumented,” even though they had Social Security numbers on file. That resulted in the program not submitting or receiving federal matching funds for those individuals. The audit noted this is a repeated problem.
- Optical providers billed for multiple eyeglass frames and fittings for the same recipient during the year. One provider billed 180 frames and 186 fittings for 41 recipients. The audited noted that this, too, is a repeated problem.
The report indicated the agencies that oversee the All Kids program are working on implementing audit recommendations.
Righter said the program needs to get the problems under control.
“It’s one thing for someone to run a program and maybe not do the best job right out of the gate (and) have someone like the auditor general come in and say, ‘Here are the problem areas, now fix them,’” he said.
“What’s so disappointing to me and my colleagues and the people who pay the bills in this state is that you have the audit findings and then you have another audit that says the same thing and then another audit that says the same thing.
“At some point, the problems need to be fixed, and I think that’s something this administration has really struggled with the last several years.”
Ultimately, All Kids is another government program that spends scarce taxpayer dollars and fails to meet expectations, said Jonathan Ingram, director of health policy and pension reform for the Illinois Policy Institute, a free-market think tank.
Ingram said that when All Kids was implemented in 2006, it was projected to enroll 204,000 children by 2011, and the predicted cost of the program by 2011 was to be $471 per child.
However, the program’s expansion provided coverage to 37 percent fewer children and at double the per-enrollee cost. And it has failed to stop the growth of uninsured children in Illinois, Ingram said, noting that between 2007 and 2009, the number of uninsured children in Illinois increased by more than 64,000.
“Although the intent of the program was to provide all children with access to health care, it simply trapped thousands of children in a Medicaid program so broken that it’s difficult for patients to access care,” he said.
“If lawmakers wanted to enact policy that actually would increase insurance coverage for children, government would reduce the mandates that make it more difficult for patients to afford insurance."