| HFS, stakeholders discuss impact of potential Medicaid cuts on Illinois
Advocates and provider groups said Wednesday that the future of Medicaid and the millions of Illinoisans it covers is uncertain as federal lawmakers consider billions of dollars in cuts to the program.
The House Appropriations-Health and Human Services Committee heard several hours of testimony on the issue Wednesday morning. Rep. Anna Moeller, a Democrat from Elgin and chair of the committee, said the discussion was meant to highlight how the proposed cuts “threaten not only individual lives but the stability of our healthcare system.”
“Since 1965, Medicaid has been a lifeline for millions of Illinoisans, ensuring that children, seniors and people with disabilities receive essential care,” she said. “But today, we know that that lifeline is under attack.”
Department of Healthcare and Family Services Director Elizabeth Whitehorn said that at the end of the last fiscal year, roughly 3.4 million Illinoisans, including 1.4 million children, were covered by Medicaid. Of those covered, 9 percent were seniors and 7 percent were adults with disabilities.
Medicaid covers over two-thirds of nursing facility days in the state and nearly half of all births.
Whitehorn said they are concerned that 770,000 Illinoisans could lose coverage if Congress cuts the Affordable Care Act’s Medicaid expansion. Illinois currently contributes $750 million to cover that population, with the federal government contributing $7.5 billion.
House Republicans last month narrowly passed a budget bill, which is the first step toward extending President Donald Trump’s tax cuts and reducing spending on Medicaid. A House proposal has called for $880 billion in cuts to programs like Medicaid.
Specific cuts or changes to the program have not been introduced, but Whitehorn told lawmakers that the reported changes would all lead to some decline in enrollment or benefits.
A per capita cap to limit federal Medicaid funding to states could cause Illinois to lose between $24 and $39 billion over 10 years.
“We’d be left to make unimaginable decisions about limiting benefits for customers,” Whitehorn said of that option.
Whitehorn said between 344,000 and 633,000 Illinoisans could lose coverage if work requirements are implemented. She said some of those would be due to administrative burdens, such as filing necessary paperwork in a timely fashion.
Another idea floated is to change provider taxes, which states use to help fund the program. The state will collect over $3.9 billion in assessments on hospitals, nursing homes and managed care organizations this fiscal year.
“We are continuing to follow all of this and continuing to assess what it means for the state of Illinois,” Whitehorn said.
Provider groups raise alarm on potential cuts
Carrie Chapman, the deputy executive director of programs and policy at the Legal Council for Health Justice and representative of the advocacy group Protect Our Care, said the future of the Medicaid program will be decided in the coming months.
“This is the line, Medicaid stays or goes as the program that we know it right now,” Chapman said.
Other advocates painted a bleak future for Medicaid patients in Illinois. Heather O’Donnell, senior vice president of public policy at Thresholds, said Medicaid is the largest payer of behavioral health in the state, particularly for people living with severe mental health conditions.
She said the ACA Medicaid expansion was a “game-changer” for their patients with behavioral health needs as it allowed them to quickly get coverage.
“Illinois has made so much progress in tackling the behavioral health crisis… putting more money back into the workforce and into providers and investing in certified community behavioral health clinics,” O’Donnell said. “We cannot go back.”
Laura Minzer, president of the Illinois Health and Life Insurance Council, noted a recent reportfrom the Urban Institute and the Robert Wood Johnson Foundation that the state’s uninsured rate could increase by nearly 36 percent if Medicaid funding for states is cut.
“If (people) do not have access to insurance, they do not have access to care, which means they’re entering the workforce sicker, thereby increasing cost pressures,” Minzer said.
Tesa Anewishki, CEO of Loretto Hospital in Chicago, said safety-net providers like theirs have become increasingly reliant on Medicaid funding to pay their workforce and upgrading their facilities.
She said safety-net providers already work on “razor-thin” margins, and any changes in Medicaid funding could threaten them.
“Without (funding), we simply perish,” Anewishki said. “Not just hospitals: patients, human beings and communities.”
Republicans call hearing ‘performative’
While federal cuts could be devastating, Rep. Bill Hauter, R-Morton, said that the past decade has seen providers deal with many cuts and funding reductions in the Medicaid program, from decreasing reimbursement cuts to prior authorization and managed care organizations.
“We have control over Illinois Medicaid, and all I have seen is cuts for a decade,” he said. “Let’s talk about that.”
Hauter also called the hearing “performative” because Congress has not introduced any specific cuts, and the General Assembly has no control over federal budget making.
“I think we were here today as a performative exercise to say, ‘(President Donald) Trump is bad,’” Hauter said.
Several Democratic committee members called on their Republican colleagues to contact the state’s three Republican Congressional members and urge them to vote against Medicaid cuts.
Per state data, more than 516,000 Medicaid recipients reside in the districts of Reps. Mike Bost, R-Murphysboro; Mary Miller, R-Oakland; and Darin LaHood, R-Peoria.
Rep. C.D. Davidsmeyer, R-Jacksonsville, said he and his colleagues care about the Medicaid program and its members. He said “grandstanding” events like Wednesday’s hearing make state Republicans reluctant to contact their federal representatives as it’ll seem “more about politics and policies.”
Additionally, Davidsmeyer said the state needs to do more to shift eligible individuals from the Medicaid program to private insurance with higher reimbursements.
Moeller disputed the idea that the hearing was performative, saying the state could lose billions of dollars as it enters its own budget negotiations.
“It’s going to make our jobs a lot harder if Congress moves directly with what they’re saying,” she said. “So I hope that we are all serious about making sure that these cuts don’t happen, and we do what we can to prevent that.” |
