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In the Illinois Valley, almost half of births are paid for by public aid

LaSalle News Tribune

Friday, August 11, 2017  |  Article  |  

Health (49) , Public Aid (75)

Mason Krisch runs around the family farm in rural Sublette.

At 2 years old, he can name the tractors and lawnmowers on the farm and knows the name of the family horse, Coco.

He’s the boss of the farm, his mom said.

“Every time he comes over, he gets a tractor ride,” said Jessie Stewart.

But two years ago, while Stewart was pregnant with Mason, it was a rocky journey for Stewart to get the care she needed.

“I was 30 weeks before I got in to see a doctor,” she said. Stewart said she signed up for the medical card as soon as she found out she was pregnant, but she needed to clear a series of hurdles. One of the biggest was that some doctors would only take a certain number of Medicaid patients and the ones she contacted were full. And once she found a doctor, there was a glitch with the card saying it had expired, even though it was new, she said.

Having a baby while enrolled in Medicaid is not unusual. The NewsTribune contacted local hospitals and found that about 50 percent of births in the area are covered by Medicaid. At Illinois Valley Community Hospital in Peru, 48 percent of the 439 births last fiscal year were covered by Medicaid. At OSF St. Elizabeth Medical Center in Ottawa, the number was 50 percent or more over the last five years. St, Margaret’s Hospital in Spring Valley reported that 40 percent of their births last year were covered by Medicaid.

Those numbers are about where Illinois is as a whole: In 2014, the Henry J. Kaiser Family Foundation estimated Medicaid covered 50 percent of births in the state.

Perry Memorial in Princeton and OSF St. Paul Medical Center in Mendota do not have obstetrics units.

When a patient comes through on public aid, the hospital is reimbursed 53 percent of their cost, said Linda Burt, vice president of marketing and community services at St. Margaret’s Hospital. This can lead hospitals to make certain decisions.

“You make choices based on what you can afford,” Burt said. But she also said those treating the patient don’t know how the patient is paying for the treatment. “Everyone is treated the same.”

Other hospitals said even looking at how a patient plans to pay for treatment is a violation of the Health Insurance Portability and Accountability Act that governs patient privacy.

“Everyone is treated the same,” Burt said.

Some Need Assistance

Stewart said she was unemployed when she found out she was pregnant.

“Up until then I knew what to do,” she said, taking vitamins and watching what she ate.

She is currently working at a restaurant in Peru and still holds the medical card for her and her son. She said when she goes to the doctor, she feels like she gets bumped to the bottom of the priority list because of the card.

“On the medical card, you’re the last person they see,” she said. Waiting two or three hours while others come and go is not uncommon, she said. “I get frustrated.

Stewart made clear she works and said sometimes people need the extra help. She’s currently living with her parents and works wherever and whenever she can to make money.

She wanted people to know most people aren’t gaming the system.

“Sometimes people just can’t afford it,” Stewart said. “They just need the help.”