SPRINGFIELD — Although the Supreme Court has barred the federal government from punishing states for failing to expand Medicaid coverage, Illinois Gov. Pat Quinn says he plans to carry out the full Affordable Care Act including expanding Medicaid rolls.

By Andrew Thomason

SPRINGFIELD — Although the Supreme Court has barred the federal government from punishing states for failing to expand Medicaid coverage, Illinois Gov. Pat Quinn says he plans to carry out the full Affordable Care Act including expanding Medicaid rolls.

The court said the federal government can’t take away Medicaid money states already are getting if they refuse to expand Medicaid programs, which the original law allowed.

But the court ruled the federal government can withhold money meant to help expand Medicaid under the Patient Protection and Affordable Care Act if states decide against expanding their programs under the national law.

“The state of Illinois is going forward with the president of our country, President Barack Obama, to expand using Medicaid (to) those that would be covered under the Affordable Care Act,” Quinn said. “That is the law. We’re not backing down.”

Quinn said that the federal assistance provided for the expansion would prevent the state’s Medicaid system from becoming too costly.

But Illinois Treasurer Judy Baar Topinka predicts Illinois will have to find $2.4 billion over the next six years if it elects to allow into Medicaid anyone who makes less than 133 percent the federal poverty level, as outlined in the act.

“Illinois is a textbook example of what can happen if financial challenges are not proactively addressed,” Topinka said. “The state needs to learn from experience, and take steps today to address the increased Medicaid costs that will occur in coming months and years.”

The Illinois Legislature and Quinn worked this spring to cut $1.6 billion in Medicaid spending for the coming fiscal year, including kicking some people out of the program and ending services for others.

The cuts came amid worries of skyrocketing costs for the health-care program – overdue Medicaid bills, without any action, would have topped $21 billion by 2017.

State Sen. Dale Righter, R-Mattoon, was on the legislative working group tasked with coming up with the cuts this spring. Righter said adding people to Medicaid will ultimately burden Illinois taxpayers as federal assistance for the expansion slowly rolls back.

“Illinois is stuck with a system that has largely malfunctioned over the last 10 years. In addition to that, in just a couple of years you’ll see the addition in upwards of a couple of hundred of thousands of people added to the Medicaid roll,” he said.

State Rep. Sara Feigenholtz, D-Chicago, was also on the legislative working group tasked with coming up with the cuts this spring. She said making sure everyone has health insurance, even if that means expanding Medicaid, is a moral imperative.

“I think it’s a major victory for countless people who’ve had the doors shut in their face in the current marketplace,” Feigenholtz said. “I’ve always believed health care was a right, not a privilege.”

Illinois has about 2 million people without health insurance.

Steven Schwin, professor of law at John Marshall Law School and co-founder of Constitutional Law Prof Blog, told Chicago Public Radio on Thursday that states such as Illinois don’t have much of an option when it comes to expanding Medicaid.

“The way the court’s ruling came out and the way the Affordable Care Act works, I think it’s going to make it very difficult for states to decline that additional funding,” Schwin said.

Schwin said other aspects of the law – the individual mandate, for example – would make it difficult for states such as Illinois not to implement most of the Medicaid expansion to ensure those without health insurance could afford it.

Thursday’s ruling has also left Illinois politicians scrambling to figure out how to set up an online health insurance marketplace, essentially a website where people can compare health-insurance prices and plans.

State Rep. Frank Mautino, D-Spring Valley, has been the lead legislator working on the exchange and said earlier this week the state wouldn’t be ready to establish an exchange by the Nov. 16 deadline set by the federal government.

The state previously received $39 million from the feds to set up an exchange. It’s unclear whether the state will have to pay that money back.

Quinn toyed with creating an exchange by executive order, but Thursday said he’d like to see it done through legislation.

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  1. Is Quinn stupid or what

    What part of obamacare didn't Quinn understand. The Federal government will only fully fund the expansion of medicaid the first year and gradually reduce funding. After 3 years the expanded funding will be the responsibility of the state. Most of the 48 states the are better off than Illinois will not expand medicaid. Their citizens that would only qualify under the expansion will move to states like Illinois.

    Let's hand out more money to buy votes. Quinn has experience here. His promises to the state unions got him elected.

  2. Medicaid spending

    One"Smart"Guy- the states share of the Medicaid spending for the new enrollees will be 10%, significantly less than the current program.

    1. You are partly correct

      "The federal government agreed to pay the full tab for the Medicaid expansion when it begins in 2014. But after three years, states must pay a gradually increasing share that tops out at 10 percent of the cost. That may not sound like much, but it translates to a commitment of billions of dollars at a time when many local officials are still anxious about the slow economic recovery." HuffPost

      For Illinois, this will be 2 – 3 billion a year. This will grow as people in need relocate to states that offer the biggest benefit. I don't blame these people but there is only so much that can be given away. I hope you are willing kick in the extra money.

      More states are declaring that they will not expand Medicaid because they can not afford the increased cost and all of those states are better off than Illinois, financially.


  3. Where does that government money come from ?

    The government and some people talk about how the federal government will fund all and then partly the new Medicaid spending.

    Where do they think the money comes from ?  We will send more money [taxes] to Washington, who will then 'take their cut' and send what is left to the states.  Like other taxes, they will create new and highly staffed agencies which will reduce the money going back to the states.  And I'm sure Congress will find many new ways to spend the tax money on pet projects that have nothing to do with Medicaid.

    Everyone always wants to think of new funding as appearing by magic with no costs.   In fact even if the government prints new money, that leads to inflatiion.  Federal and State deficits lead other countries [and taxpayers] to demand higher rates for money they lend—and credit ratings drop.  Even foreign trade eventually gets effected.

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