Progress Illinois

When pressed to come up with ways to address the state's gaping budget deficit without raising income taxes, Illinois Republicans and conservatives love to bring up former Gov. Rod Blagojevich's unilateral expansion of Medicaid. (In 2007, he issued an emergency regulation that increased income eligibility for the state's FamilyCare program from 185 percent of the federal poverty level to 400 percent -- equivalent to $83,000 for a family of four.)  Below are a few examples:

State Sen. Carole Pankau (R-Itasca): "Start looking at some of the illegal programs that the former governor put in place without any General Assembly approval to do that. ... The largest segment of our budget right now is Medicaid. That is our 600-pound gorilla."  (ABC 7's NewsViews, 6/7/09)

Illinois Policy Institute chairman John Tillman: "In 1998, there were 1.7 million people receiving Medicaid benefits.  Today there are 2.7 million people receiving Medicaid benefits. And yet the rate of insured is the same.  The reason that's happened is that we've raised the eligibility for Medicaid so that a man or woman or family making $80,000 is now getting taxpayer-subsidized health care." (WTTW's Chicago Tonight, 4/16/09)  

Chicago Tribune Editorial Board: "Quinn should drop the expensive and likely illegal expansion of coverage under Blagojevich: Roll back the FamilyCare program to levels legislators approved." ("12 Steps Before A Tax Hike," 3/17/09)

State Sen. Matt Murphy (R-Palatine): "Governor Blagojevich's failed Medicaid expansion has been a boondoggle -- roll it back." (WFLD's Fox Chicago Sunday, 3/15/09) 

And our personal favorite: 

Potential gubernatorial candidate Dan Proft: "Gov. Blagojevich, one of the charges for which he was impeached was for illegally expanding Medicaid to 400 percent of the poverty level. ... Blagojevich is gone.  That illegal expansion of that benefit is not.  Doubling the eligibility of Medicaid has resulted in a 33 percent increase in Medicaid spending by the state just in the last three fiscal years ... They're projecting about $18 million in Medicaid spending [in FY 2010].  So it would save you about $5 billion." (Public Affairs with Jeff Berkowitz, 6/2/09)

There are two reasons why citing Blagojevich's FamilyCare expansion in the context of the budget debate makes zero sense.

First, the idea that rolling it back would have any real effect on the budget deficit (let alone wipe out $5 billion, as Proft claims) is ridiculous.  As of February 2008, only 3,300 individuals had signed up under the new eligibility criteria.  At the time, the state estimated that this boost would raise the state's Medicaid liability by about $14 million annually.  A lawsuit ultimately halted the expansion in September 2008 and a lengthy legal battle ensued. 

John Bouman, president of the Sargent Shriver National Center on Poverty Law, told us that he saw filings associated with the lawsuit stating that, at most, 4,000 people enrolled under the expanded FamilyCare guidelines.  He confirmed that the estimated annual cost was close to $14 million and added that, in the process of wrapping up the lawsuit, the enrollment number was lowered to about 3,000.  Bouman further noted that the income eligibility level in Illinois has since been dropped to its earlier level.

Now that you've got those facts, watch Proft -- in full technicolor -- falsely claim that the FamilyCare expansion "has resulted in a 33 percent increase in Medicaid spending by the state just in the last three fiscal years":

Republicans like Proft, Murphy, and Pankau clearly like the idea of tying the deficit to Blagojevich's "illegal" acts.  But the problem is much bigger than that.

Which brings us to the second point: The largest expansions of Medicaid in Illinois actually took place under a Republican administration.

In their report (PDF) released last week, the Taxpayer Action Board (TAB) included this helpful summary of Medicaid policy changes over the past decade (notice that the 2007 FamilyCare expansion isn't even mentioned):

[I]n July 2000 the income eligibility threshold for the aged and disabled population was increased. This change alone has resulted in approximately 136,000 new enrollees in this category. In October 2002, the income standards for parents of low-income children, already eligible for coverage, were also increased, adding another 170,000 enrollees to the program… Finally, beginning with the enactment of legislation covering all uninsured children of any income level in November 2005, Illinois began an aggressive public relations campaign to promote enrollment of children in the All Kids health insurance program. This campaign has resulted in 68,600 additional children being added to the Medicaid program.

The 2000 and 2002 expansions both took place under Republican Gov. George Ryan. Not surprisingly, as Capitol Fax notes, the Medicaid system "grew fastest" during his term (1999-2003).  Pankau was even a co-sponsor of the 2000 bill, which passed both chambers unanimously.  Below is a useful graph from the TAB report:

To be clear: The expansions that took place under Ryan were good public policy and the Republicans deserve credit for supporting them.  But those trying to claim that the growing Medicaid liability is simply Blagojevich's fault should be laughed off the stage.