SPRINGFIELD, Ill. (AP) – A Springfield medical group is requiring patients insured by the state to pay half of their expected surgery bills up front.

The State Journal-Register reports that the requirement from the Orthopedic Center of Illinois comes at a time when payments for the care of state workers, retirees and dependents insured through the State Employees’ Group Insurance Program total $3.66 billion – and are overdue a year and a half or more.

Those delays have grown amid the lack of a permanent state budget.

Illinois State Board of Education employee Gaile Brickler Bee says the policy could require her to pay about $2,800 before she gets a rotator-cuff surgery at the center. The 62-year-old says she is frustrated by the policy and blames elected officials more than the center’s doctors.