SPRINGFIELD — The federal government is promising billions if Illinois expands its Medicaid program, but lawmakers are wary.

By Benjamin Yount

SPRINGFIELD — The federal government is promising billions if Illinois expands its Medicaid program, but lawmakers are wary.

Illinois Health Care and Family Services Director Julie Hamos told a statehouse committee Monday that Illinois could see more than $1 billion a year in reimbursements from the federal government by expanding Medicaid to cover childless adults who make about $15,000 or less a year. These are the same people targeted for coverage by the Affordable Care Act.

The money, Hamos said, “will go right back out to the (health-care) providers and local governments who have been providing care for low-income adults.”
Hamos said about one million people in the state don’t have health insurance. She estimates 520,000 of those people would become eligible for Medicaid under an expansion, and the rest would have to buy private health insurance through the state’s insurance exchange.

The federal government is promising to pay 100 percent of the costs for anyone covered by a Medicaid expansion from 2014 to 2017, and no less than 90 percent of the costs from 2017 until 2020.

But state Rep. Patti Bellock, R-Westmont, said there is no guarantee Illinois will see all of those promised dollars once President Obama leaves office.

“What happens in the outer years?” Bellock asked Monday. “Will that be changed to maybe a 65 percent rate? I don’t know what will happen those years.”

Bellock also has questions about Illinois’ expectations that only a half million people will enroll into an expanded Medicaid program.

The Kaiser Family Foundation has released a report that suggests as many as one million people would enroll and that 600,000 would be “newly eligible” under a Medicaid expansion.

Bellock is terrified that if the federal government eventually reduces Medicaid reimbursement rates, Illinois will be stuck with billions of dollars in health-care costs it can’t afford.

Hamos says she does not trust the federal government, either, but the Supreme Court has given states a clear answer about future “what if’s.”

“I think if this was just left to the feds … we would be just as cautious as you are,” Hamos said. “But the United States Supreme Court has laid out the basic tenants. The U.S. Department of Health and Human Services has said they cannot impose this on the states.”

State Rep. Sarah Feigenholtz, D-Chicago, says there is simply too much available cash to not open Illinois’ Medicaid rolls.

“We are already spending this money. This is just a cost shift, and finally getting a match,” Feignholtz said as she shepherded the Medicaid expansion plan through an Illinois House committee.

Illinois first approved a Medicaid expansion moratorium in 2011, and then again in 2012. Hamos’ requested expansion would end that moratorium.

The new proposal faces a tight deadline. If the Illinois Legislature fails to approve the proposal by noon Wednesday, it could be summer before lawmakers take up the issue.

Hamos says Illinois is finally trying to get ahead of problem.

“This is going to take a while to get right,” Hamos said “So we need this expansion now.”

Contact Benjamin Yount at Ben@IllinoiisWatchdog.org

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1 Comment

  1. What are the rules

    If we expand now and the federal government does not keep its word, can't we back out later? We let people in. If all goes well, we keep the in the plan, otherwise we kick them out of the plan.

    It is not like the taxpayers will be paying for this. I'm sure China will be left holding the bag.

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