Julie Hamos, Director, Illinois Department of Healthcare and Family Services

( January 7, 2013 )

Why we're watching: Hamos, who runs the state's Medicaid program, returns to the list this year, facing more battles with health care providers.

The 63-year-old former legislator has four tasks, each of which are herculean.

She'll continue implementing the $1.6 billion in Medicaid spending cuts enacted by the Illinois General Assembly under the 2012 SMART Act.

She'll be moving more than 1 million poor or disabled Illinois Medicaid recipients into some form of managed care (similar to HMOs). Late last year, the Tribune reported that Hamos ordered the state to withhold more than $5.1 million in Medicaid payments from 11 medical centers after they failed to meet a deadline to sign up with one of the two state-approved insurance plans.

"Carrots and sticks are what we use," she said. "That was a bit of a stick, and I think it worked." She later added: "You saw some of that resistance, and that's going to be multiplied (in 2013). That was 40,000 people (moving into managed care). This is 1 million-plus people."

She'll also be implementing a new payment system for hospitals and nursing homes, and she will try to win General Assembly approval to expand the Medicaid program to include very low-income individuals without children.

Hamos explained that this coverage was mandated by President Barack Obama's health care overhaul, but the U.S. Supreme Court made it optional for states, hence the need for legislation.

"All of these things are very tough," she said. "The Medicaid program is not going to look the same one year from now. It's the biggest change in Medicaid ever."

Photo: Illinois Department of Healthcare and Family Services director Julie Hamos answers questions during the workgroup meeting in July. (Heather Charles/ Chicago Tribune)