 The Illinois Department of Healthcare and Family Services, which
administers Medicaid, asked the federal government to approve
accelerating the expansion of the state-federal health insurance
program under the federal Patient Protection and Affordable Care
Act.
The request seeks to add 100,000 childless, low-income Cook County
residents to the Medicaid program two years before the federal
health care act requires their enrollment.
Medicaid funding normally is split equally between the state and the
federal government. But the cost of the expansion would be split
between Cook County and the feds, with each paying around $125
million in tax dollars annually.
These are costs Cook County would be paying anyway to care for
low-income patients who show up at the emergency room because they
can't afford a doctor's visit. Cook County is simply looking to
recover some of those expenses, said Mike Claffey, a spokesman for
the state's Department of Healthcare and Family Services.
But this expansion could affect downstate taxpayers, state Sen. Dale
Righter, R-Mattoon, said.
"People in my district, they pay state taxes, they also pay federal
taxes," Righter said. "And they care how much their governments are
spending, not just in Springfield but in Washington (D.C.) as
well."
Righter voiced concern that the state would be stuck with paying for
the 100,000 new enrollees if the federal health care law is struck
down in whole or part by the U.S. Supreme Court before the end of
this year, since their eligibility is based on the new law.
Beyond approval at the federal level, the expansion requires state
lawmakers to revisit Medicaid changes they approved last year
that suspended the addition of more people to Medicaid.
Last year's reform also sought to expand income verification and
residency checks for participants in an effort to prevent fraud.
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But those changes haven't gone into effect, because the state has
not received a waiver from the federal government. The federal
health care law prohibits shrinking the state's Medicaid programs to
levels below those set in March 2010 without a federal waiver.
California, Connecticut, Minnesota, New Jersey, Washington state and
Washington, D.C., have taken similar steps to those being sought by
Cook County, according to the Kaiser Family Foundation, a think tank
that focuses on health care-related issues.
State Rep. Patti Bellock, R-Hinsdale, said every case is different.
"A lot of other states are not in the similarly fiscal crisis we are
in. So we just ask for flexibility," she said.
If nothing changes, the state will end up having $21 billion in
unpaid Medicaid bills by 2017, according to a report released Monday
by the Civic Federation, a nonpartisan group that focuses on
budgetary matters.
Without changes, Medicaid will consume 40 percent of the state's
general revenue fund by 2017, the federation predicts.
Laurence Msall, president of the Civic Federation, said the waiver
would help the Cook County Department of Public Health, which has a
deficit of $120 million, $39 million of which could be erased if the
state processed Medicaid applications faster.
[Illinois
Statehouse News; By ANDREW THOMASON]
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