The Republican health plan currently in Congress would remove $40 billion from the Illinois’ current Medicaid program over the next 10 years, according to numbers from the Congressional Budget Office. The Illinois Hospital Association says they expect over 400,000 Medicaid recipients to lose coverage.
The largest factor for the state comes from dismantling the Affordable Care Act’s Medicaid expansion, which Illinois chose to accept. In its first three years of operation, 650,000 new people in the state got coverage under Medicaid.
The Hospital Association says if Illinois tried to keep Medicaid eligibility at current levels, it would come at a cost of $3.5 billion a year.
But there's even a twist in that, says Felicia Norwood, director of the Illinois Department of Healthcare and Family Services. Current state law says if the federal government isn’t funding at least 90 percent of recipients’ healthcare costs under the Medicaid expansion, Illinois won't pick up the difference — coverage will simply be dropped.
Then there’s the new funding limits the proposal would create. It would essentially set in stone the reimbursement rate the feds currently give to Illinois’ Medicaid system. “Illinois has always been at the bottom based on the fact that Illinois is considered a wealthier state,” says Norwood.
But federal contributions for Illinois are not just low because Washington thinks it already has the money. Joe Holler, a vice president of the Illinois Hospital Association says the state has been low-balling its own Medicaid rates — how much the state pays doctors and hospitals when a recipient gets care — for years. That’s the final dollar amount the feds end up matching.
“We have been reducing, controlling the cost of our Medicaid program on a per-beneficiary basis over the last decade,” Holler said. “This will now be our benchmark going forward, where other states potentially did not have those budget situations, and were able to spend more.”
The Hospital Association worries that if the Republican healthcare plan passes as is, those low contributions to Illinois could be locked in until 2026.