The Illinois Department of Public Health said nine rural hospitals in Illinois would face closure or severe service reductions due to the cuts.
Photo: Capitol News Illinois/Andrew Adams
President Donald Trump raises his fist at the Republican National Convention in Milwaukee last year alongside U.S. Rep. Steve Scalise (left) and then-running mate J.D. Vance (right). His largest domestic policy bill, which makes drastic cuts to Medicaid, appeared poised to become law last week.
by Peter Hancock
Capitol News Illinois
Medicaid and the health care marketplace
Medicaid, which is jointly funded by states and the federal government, provides health coverage for lower-income individuals and families. It was established in 1965 alongside Medicare, the federally funded health coverage program for people over 65. Today, according to the Illinois Department of Healthcare and Family Services, the program covers about 3.4 million people in Illinois, or a fourth of the state’s population. At a total cost of $33.7 billion a year, it is one of the largest single categories of expenditures in the state’s budget. It pays for about 40% of all childbirths in the state, according to KFF, as well as 69% of all nursing home care. But questions about its future loomed over the Illinois General Assembly during the just-completed legislative session as both Congress and the General Assembly were crafting their respective budgets for their upcoming fiscal years. “This was a difficult year because of the unprecedented changes and cuts that are looming on the horizon in Washington,” state Rep. Anna Moeller, D-Elgin, said on the floor of the Illinois House during debate over a Medicaid bill on the final day of the session. Speaking with reporters at an unrelated event Tuesday, Pritzker predicted “hundreds of thousands” of people in Illinois will lose Medicaid coverage if the Senate bill is signed into law. “This is shameful, if you ask me, and it’s going to be very hard to recover,” Pritzker said. “The state of Illinois can’t cover the cost – no state in the country can cover the cost of reinstating that health insurance that is today paid for mostly by the federal government, partly by state government.”Policy changes under the bill
According to KFF, most of the reductions in Medicaid spending would result from just a few policy changes contained in the bill Those include imposing a work requirement on adults enrolled in Medicaid through the Affordable Care Act, also known as “Obamacare.” That law expanded eligibility for Medicaid to working-age adults with incomes up to 138% of the federal poverty level. About 772,000 people in Illinois are enrolled under that program. The bill also calls for requiring people enrolled through the ACA expansion to verify their continued eligibility for Medicaid twice a year instead of annually. That is expected to filter out enrollees whose incomes rise above the eligibility limit as well as those who simply fail to complete the verification process. Another provision would limit the ability of states to finance their share of the cost of Medicaid by levying taxes on health care providers. Illinois imposes such taxes on hospitals, nursing facilities and managed care organizations that administer the program. Revenue from those taxes is used to draw down federal matching funds that are then used to fund higher reimbursement rates to health care providers. The final version of the bill does not, however, include a provision penalizing states like Illinois that also provide state-funded health care to noncitizens who do not have lawful status to be in the United States. That provision, which was included in the earlier House version, was not included in the Senate bill, according to KFF.
Capitol News Illinois is a nonprofit, nonpartisan news service that distributes state government coverage to hundreds of news outlets statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation.
