When the U.S. Supreme Court endorsed the fundamental legality of the Affordable Care Act in June, it left open the option for states to decide on various aspects of participation, including the Medicaid expansion.
“Illinois should take advantage of a unique opportunity to offer health care coverage to hundreds of thousands of low-income residents,” the report reads. “Given that the federal government will provide nearly all of the funding, extending Medicaid eligibility is a very good bargain for Illinois. We can’t afford to pass up this valuable opportunity.”
Expanding Medicaid eligibility under the Affordable Care Act (ACA) would extend Medicaid to 15 million people nationwide, including all childless adults younger than 65 with an annual income of 133 percent of the federal poverty level ($15,414 for an individual in 2013).
The Illinois Department of Healthcare and Family Services (HFS), the state’s main Medicaid agency, estimates that Illinois will have more than 500,000 new Medicaid recipients by 2017, with more than 300,000 meeting the new eligibility requirements. Medicaid already covers 2.7 million of the state’s 12.8 million residents.
The federal government will pay 100 percent of the cost for the new Medicaid population for the first three years of the program and gradually phase down to 90 percent by 2020.
Saying, “we must act now” and “we have work to do,” Gov. Pat Quinn spoke in support of the Medicaid expansion package in his State of the State address earlier this month. He also called for the establishment of a state health insurance exchange.
“I call on the General Assembly to increase access to health coverage for the uninsured through Medicaid and to create the Illinois Health Insurance Exchange,” he said.
If Illinois were to pass the exchange, it would be one of 18 states along with the District of Columbia to offer marketplaces where, as the ACA requires individuals to carry health insurance and businesses with at least 50 employees to offer it to their workers, companies and individuals who don’t qualify for Medicaid can buy coverage.
“This will really benefit the state as a whole,” said Larry Joseph, director of the Fiscal Policy Center at Voices For Illinois Children and author of 'Closing the Medicaid Coverage Gap.'
“It will bring in new federal resources for Illinois, it contributes to having a healthier work force and lowers the mortality rate.”
To ensure states do not incur costs over time, a fear expressed by several Republicans, a provision was added to the Medicaid expansion package, saying that if the federal matching rate drops below 90 percent for funding newly-eligible people, the expansion will be stopped.
“Illinois has a major challenge with the uninsured, about 1.8 million people,” said Danny Chun, spokesperson for the Illinois Hospital Association. “We think the Affordable Care Act, including Medicaid expansion and the establishment of the health insurance exchange, are important steps toward achieving that goal of increased coverage and access.”
Along with the Illinois Hospital Association and Voices for Illinois Children, other supporters of a Medicaid expansion in Illinois include the Illinois Chamber of Commerce, the Illinois Retail Merchants Association, health departments in DuPage County and Lake County, the Illinois Primary Health Care Association, the Community Behavioral Healthcare Association of Illinois, and the Association of Community Mental Health Authorities of Illinois.
“In many cases, unfortunately, hospital emergency rooms are the first and last resort for healthcare for the uninsured, they don’t have anywhere else to go, they don’t have a doctor,” said Chun. “Many times they wait until a condition becomes very serious and end up going to the emergency room in an emergency when it could’ve been prevented or substantially medicated or reduced.”
“Ultimately it’s about people, and making sure they get the care they need so they will be healthier, so they can get the right care, in the right time and in the right place."