Governor to sign Medicaid expansion

By Jamey Dunn

Gov. Pat Quinn is expected to sign a massive Medicaid expansion, which is a key piece of federal health care changes, approved by the Senate today.

Senate Bill 26 would allow people who have a household income of 133 percent of the poverty level to qualify for Medicaid. The federal government will pick up the cost of the expansion until 2017, when the funding drops to 95 percent. In 2020, federal support will drop to 90 percent. The U.S. Supreme Court’s ruling on the Patient Protection and Affordable Care Act, sometimes dubbed “Obamacare” after President Barack Obama by its opponents, allowed states the option not to participate in the Medicaid expansion. (For more on the ruling and the expansion, see Illinois Issues September 2012.) The Department of Healthcare and Family Services estimates that an additional 342,000 residents would be eligible for Medicaid under the bill. About 140,000 more who are Medicaid-eligible but not enrolled will also likely sign up for Medicaid when the federal mandate that requires Americans to have health insurance kicks in 2014.

Republicans spoke out firmly against the bill, saying that it makes no sense to add more Medicaid patients after cutting the program by more than $1 billion last year. “Only in Springfield would we take a program that has been mismanaged and is unaffordable” and add more people to it, said Sen. Dale Righter, a Mattoon Republican. “We cannot afford this. Other states have rejected it. We should reject it, too,” said Hinsdale Republican Sen. Kirk Dillard

Chicago Democratic Sen. Heather Steans, sponsor of SB 26, acknowledged the state’s budget problems, but she said the expansion is an opportunity to offer health care to people who truly need it and have the federal government help pick up the tab for services that governments and hospitals are paying for now. She noted that several business groups in the state, including the Chamber of Commerce, support the measure.

Some Democrats spoke out against the bill, but not because of the Medicaid expansion. The House tacked changes to last year’s Medicaid reforms that will roll back some of the limits for various populations. However, some members of minority caucuses argued that the cuts should have been reduced even further. “We’re talking about the sickest here in this state and many who were born that way,” said Chicago Democratic Sen. Donne Trotter. “My opposition is because it doesn’t go far enough to protect them.” He said recent reductions to state programs for the mentally ill and those battling addiction have left many of Illinois’ poor with no options. Opponents also said that they wanted Medicaid dental care restored. The changes last year cut dental care to emergency services only.

Steans, who sponsored the legislation cutting Medicaid last year, said she did not celebrate the passage of that bill after months of negotiation. “I went into my office, closed the door and sobbed for a very long time.” She said that cutting Medicaid last year was difficult but necessary. She added that she is open to restoring more of those cuts in the future if the state’s budget situation improves. But Steans said that “today is a much happier day” because more people will get access to health care under the Affordable Care Act. Quinn supports the measure and issued a statement today saying he intends to sign it.