SHARE THIS EMAIL

Medicaid expansion The Illinois House voted Monday on a measure that will add hundreds of thousands of  low-income adults to the state’s Medicaid roles costing federal and state taxpayers billions of dollars. Lawmakers in the House endorsed the measure 63-55. “The problem with this bill is that there is so much uncertainty,” said state Rep. Patty Bellock, R-Hinsdale. “Some estimates say it will add 300,000 people to Medicaid, the Kaiser Foundations says 500,000, other estimates say 700,000.” But the uncertainty goes beyond how many people will sign up for Medicaid. The federal government says it will pay 100 percent of the cost the first three years for newly eligible enrollees and then pick up 90 percent after that. “But now they are talking about changing the rates that they will reimburse us,” Bellock said. ”But we don’t know what the new rates will be or what they will cost us. These uncertainties are why 25 states have refused to expand Medicaid  – and we are in worst shape than most states and can’t afford to make a mistake. “ Gov. Pat Quinn favors the measure and U.S. Sen. Dick Durbin, D-Illinois, visited the Illinois House during debate to lobby Democrats to support the expansion. Although the U.S. Supreme Court ruled most of Obamacare as constitutional – the portion requiring states to expand Medicaid coverage didn’t pass constitutional muster. It’s now up to individual states to determine whether to expand who is eligible for Medicaid. “To me it's a cost saving measure. The economy will turn around and we'll be in a better position to pick up the costs. With 100 percent funding from the federal government there is little risk,” said state Rep. Mike Smiddy, D-Hillsdale. The bill passed without a single Republican vote. “The potential is there for a huge increase in cost for state government, when we are not paying our bills, not funding pensions and we reduced education spending this year,” said state Rep. Don Moffitt . “It is unwise to start a program that in all probability will increase expenditures in future.” Jonathan Ingram, a senior fellow with the Illinois Policy Institute, said even with the federal government’s pledge to pay 100 percent of the cost for newly eligible enrollees for the first three years, the state will still be on the hook for paying for the administrative costs of enrolling these people. He said the state may have to hire hundreds of employees just to handle the enrollment of hundreds of thousands of people into Medicaid.  “There is also the question of whether or not we could opt out if it doesn't work out,” Moffitt said. “We didn't need pass this just yet. We could have waited for more answers from the federal government and voted on it in the fall. With budget cuts at the federal level, what guarantee do we have that this program would not be cut?”   Scott Reeder Veteran Statehouse Reporter and Journalist in Residence Illinois Policy Institute sreeder@illinoispolicy.org