Gov. J.B. Pritzker’s veto leaves door open for yet-to-surface Medicaid buy-in plan

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Gov. J.B. Pritzker left open the possibility of requesting a waiver from the federal government to expand Medicaid as an option for people to buy into, something he proposed while campaigning for governor.

During the campaign, Pritzker said he wanted to investigate an insurance option to have the public buy into the Medicaid program. That would require a waiver from the federal government.

Pritzker vetoed a bill Friday that would have restricted that waiver process. He said former Gov. Bruce Rauner’s administration was looking to limit federal benefits for Illinoisans.

“That’s not at all my goal,” Pritzker said. “My goal is to expand coverage for people. That’s the purpose of this.”

Asked Tuesday if the Medicaid buy-in plan in one expansion he’s eyeing, the governor said: “that’s one area to do it, yeah.”

Davesurance.com insurance broker Dave Castillo said although he doesn’t know the details of the possible plan, he sees some problems, including putting more stress on an already stressed Medicaid system.

“The state is going to have to negotiate contracts for these added numbers to the Medicaid rolls and this is going to result most likely in even more narrow networks,” Castillo said. “Medicaid networks are currently fairly narrow compared to the commercial plans so your list of doctors and hospitals might be limited. For that matter, people are already upset about how narrow the [Affordable Care Act] plans, the Obamacare networks have become.”

Castillo said people buying in could have trouble finding a doctor.

“They literally are responsible to go find a doctor that’s going to take it and those folks are the ones, the bills on those, they often take forever and a lot of the doctors who are doing that aren’t doing it as much,” Castillo said.

It’s unclear when a plan could surface, but Castillo said it would be best to get the proposal out for a thorough debate. He also said it’s unclear how the medical community would respond to a Medicaid buy-in plan, were it ever to be revealed.

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July 30, 2019 at 05:29PM

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