Eye On Illinois: Self-appointed power comes with responsibility to follow through

We try to address a wide variety of state government topics here at Eye On Illinois, but even while spraying to as many fields as possible there are unavoidable trends.

One such theme is lack of follow through. Put another way: the state giving itself more power than it can effectively exercise.

Consider last week’s Capitol News Illinois report about lawmaker hearings examining the role of pharmacy benefit managers, the third-party intermediaries that negotiate prices pharmacies and health insurers pay to source prescription drugs from the manufacturers.

The issue is more complex than that summary, but one part is easily understood yet impossible to grasp:

“Joe Butcher, of the auditor general’s office, told lawmakers on the Legislative Audit Commission that the Illinois Department of Healthcare and Family Services failed to collect documents relevant to state Medicaid spending, which it is responsible for overseeing,” according to CNI’s Dilpreet Raju. “Without necessary documents, Butcher said, the state cannot adequately exercise oversight authority.

" ‘HFS was not engaging in monitoring practices of PBMs as mandated by the Illinois Public Aid Code, which establishes several provisions for monitoring PBMs,’ he said.

“HFS Director Elizabeth Whitehorn, who was appointed in January, said she was not sure how HFS failed to obtain documentation from entities under its watch.”

This isn’t the first time lawmakers have tasked a state agency with an important function only to find it apparently unmanageable. In October 2020, the backlog for Firearm Owners Identification and concealed carry license applications cleared 168,000, jeopardizing Second Amendment rights, along with duck and deer hunting seasons.

In November, lawmakers unanimously approved a plan to address persistent problems with the Department of Financial and Professional Regulation’s paperwork logjam, which had providers of mental and physical health care waiting up to eight months for license renewals. In March, General Assembly Republicans introduced a suite of legislation after the November plan proved insufficient.

There are sound legal arguments behind wanting to regulate PBMs and license doctors, but if the agencies expected to fulfill those duties can’t get things done in a reasonable time or don’t even take the steps needed to conduct a valid evaluation, the failures increase the possible legal action challenging the underlying authority.

FOID failures have put the state in precisely that position, forcing the Attorney General’s Office to defend an exercise of power in the interest of keeping guns away from people with mental illness and felony convictions against lawyers who argue perpetual inefficiencies impose too great a burden on law-abiding Illinoisans.

The more the state fails to meet self-given responsibilities – these examples are by no means an exhaustive list – the easier it is for voters and taxpayers to question any attempt to maintain and increase power.

• Scott T. Holland writes about state government issues for Shaw Local New Network. Follow him on X @sth749. He can be reached at sholland@shawmedia.com.