Gov. Pat Quinn says he is still waiting
for numbers from the state about how much the the Medicaid expansion
passed in the Senate health care bill will cost Illinois. But with the
Senate poised to change how the
expansion is funded through the budget reconciliation process, we wanted to update our previous back-of-the-envelope estimate.
The Illinois Medicaid program cost $12.6 billion in FY 2007. That includes the combined contributions of both the state and federal government. At that time, there were approximately 2.42 million enrolees,
meaning the cost per patient is roughly $5,227. If 500,000 additional folks in
Illinois are granted access (which is close to most estimates), that
will increase the overall cost by approximately $2.6 billion annually. Herein lies the $2 billion figure that Republicans are claiming the expansion would cost the state over the next decade.
The crucial context they've chosen to leave out, however, is that that the federal government will pick up the tab for
most of the extension. After covering the full cost until 2016, Washington will cover 95 percent of the expansion in 2017, meaning Illinois would need to
pay an additional $130 million that year. In 2018, the federal assistance drops
to 94 percent, costing Illinois $156 million. In 2019, it drops one
more percentage point, adding $183 million to the state budget. That means
the grand total Illinois would owe, between 2014 and 2019, will be approximately $469
million. Thought about another way, Illinois will extend health
coverage to about 5 percent of its population at a cost of just $40 per
person annually.
