There are two populations of health care beneficiaries tied together in the litigation prompted by the governor’s unilateral expansion:

First, there are people targeted by the governor’s FamilyCare expansion. They earn between 185 and 400 percent of the federal poverty level. Previously, they would not have qualified for FamilyCare, but under the governor’s rules – now blocked by the court injunction – they would.

Second, there are people earning between 133 and 185 percent of the federal poverty level. My sources tell me there are roughly 25,000 people in this class; the governor’s administration says there are 30,000. These people enjoyed coverage through FamilyCare prior to the governor’s proposed rule changes, the first of which was filed in November.

However, these people were covered via a waiver – a pact between the federal and state governments – that expired at the end of last September. The feds agreed to reimburse the state for the cost of this population at an enhanced rate – 65 percent versus 50 percent, the standard rate at which the feds reimburse Illinois for Medicaid costs — but only through the end of last September.

The feds covered this cost through a program known as SCHIP, rather than through Medicaid. Medicaid is the core state/federal program. SCHIP is layered on top of Medicaid. At the end of September, the agreement under which the feds covered 65 percent of cost related to providing health care for adults between 133 percent and 185 percent of FPL expired.

So, the governor’s administration decided to move this class of individuals over to Medicaid. By moving them to Medicaid, the state would get reimbursed by the feds at a rate of 50 percent – not as great as 65 percent, but much better than nothing.

Only, the administration needed to first change its rules in order to move them from SCHIP to Medicaid.

The administration could have filed a rule pertaining simply to this class of individuals. But it did not. Instead, it opted to marry the necessary rule change with another rule change the governor sought to implement his much more dramatic expansion. The administration presented the two rule changes as one, first in the form of the emergency rule filed last November and second in the form of the permanent rule filed early this spring.

As you may know, both the emergency and permanent rules are tied up in court. The administration has not taken any action to deal exclusively with the rule problem relating to class of 25,000 or 30,000 folks covered via the federal waiver through the end of last September. Rather, the administration continues to address this class – in court and otherwise – together with the class targeted by the governor’s expansion.

When the governor’s administration recently ordered health care workers to stop enrolling folks into the governor’s expanded program, it ordered them to strip enrollment all the way back to 133 percent of the federal poverty level. They’re not just blocking enrollment to the program that the governor sought between 185 and 400 percent; they’re also blocking enrollment to the program that previously existed, via the federal waiver, through the end of last September.

However, it’s interesting to note that the governor’s administration has repeatedly insisted in its communications with me that health care for this class of 25,000/30,000 people in uninterrupted by the court injunction. Yet, you indicate they cut you off.

I don’t know your situation, but it’s possible you may be among some people who are still legally entitled to coverage but have gotten sucked into this mess because HFS says they cannot distinguish between the authorized and unauthorized claims.