Crespo Legislation to Protect Quality Care for Children with Severe Medical Conditions

SPRINGFIELD, Ill. – State Rep. Fred Crespo, D-Hoffman Estates, has introduced legislation that will ensure that medically fragile children covered by Medicaid are no longer moved into programs with high denial rates and decreased care.

“Every family, regardless of income, should have access to quality health care,” Crespo said. “It’s become clear that the Managed Care Program is not providing families the benefits it promises, as families in my community believe it puts their children’s health at risk.”

Crespo is the chief sponsor of House Bill 4736, which would protect the care medically fragile children receive through Medicaid by prohibiting the Department of Healthcare and Family Services (HFS) to enroll or transition them into the state’s Medicaid Managed Care Program (MCO). Additionally, Crespo’s legislation would allow children with severe medical conditions currently enrolled in the state’s MCO program to unenroll, and receive Medicaid services through the state’s traditional Medicaid program.

There about 1,000 medically fragile children in the state’s Medicaid system. About a year ago, these kids were moved into the Managed Care program. In almost every other state, children who are medically fragile have been excluded from managed care. The few states that have attempted managed care have seen detrimental consequences. For example, in Texas, a child who could not breathe on his own, had his ventilator denied, and Iowa saw several cases of people dying due to homecare being reduced by the MCO.

“It is one thing to put people with conditions like diabetes into managed care. It’s another thing entirely to put children with ventilators and feeding tubes into this program,” Crespo said. “It is my hope that the troubling findings into this program will help my colleagues understand the severity of the situation so that we’re able to work together to ensure children lives are not put at risk.”