Illinois Democrats & Republicans plan to vote on implementing Obamacare in our State as early as this Tuesday May 22, 2012.
As early as this coming Tuesday, May 22, 2012 Governor Quinn, Illinois Democrats and some Illinois Republicans will be voting to implement the most fiscally onerous part of Obamacare in our state nearly 2 years early. Namely, the massive expansion of Medicaid eligibility to nearly 800,000 new Illinois residents via a state based “Obamacare health insurance exchange”. Why are they attempting to do so now? Because, the U.S. Department of Health and Human Services (HHS) doled out another $181 million of your money in health insurance exchange establishment grants this past Wednesday, bringing the total amount of money that the federal government has pumped into state efforts to craft the “Obamacare exchanges” to more than $1 Billion. Illinois’ share was $32.7 Million.
The Obamacare legislation mandates that States must demonstrate by Jan. 1, 2013, that they can operate an exchange (which opens for enrollment in October 2013) or that they manage a partnered exchange with the federal government. Otherwise, HHS will fully oversee the creation and management of a state’s exchange. Even though this timeline for this mandate is quickly forthcoming it is grossly irresponsible for Governor Quinn to threaten an executive order and subsequent vote to implement an Obamacare exchange when the Constitutionality of this legislation will be ruled on by the U.S. Supreme Court less than a month from today.
The following is an explanation of the failed rationale behind their attempt to do so and the reasons why all fiscally responsible, limited Government advocates must contact their local representatives tomorrow (Monday May 21, 2012) in order to inform them as to why they must vote to repeal this onerous additional burden to the tax payers of the state of Illinois as outlined, in part, in the following sections of the Obamacare legislation:
A.) 2001(b) of the Obamacare legislation outlining the “Medicaid Maintenance of Effort requirement (MOE)”
B.) Sections 1311, 1321 and 1401 of the Obamacare legislation which mandates Federally subsidized “premium tax credits” for “Obamacare insurance exchange” enrollees.
Under the Obamacare ‘MOE’, a state would lose all federal Medicaid funding if it makes even the slightest change to the current Medicaid eligibility standards that were in effect prior to the passage of Obamacare.
This essentially freezes our state’s eligibility requirements regardless of the impact on Illinois’ bottom line. Not only is Illinois forced to keep eligibility at that level, but Illinois is also forced to raise payments to primary care physicians. Section 1202 of H.R. 4872 a.k.a. the “Health Care & Education Affordability Reconciliation Act of 2010” (which was used to pass the PPACA) requires that Illinois increase Medicaid reimbursement rates for primary care physicians to the same level as the applicable Medicare reimbursement rates for years 2013 and 2014. At first this sounds like a good idea however, this requirement, along with the federal funding for it, expires on January 1, 2015. Leaving the state of Illinois tax payer holding the bill to maintain this new physician reimbursement or make drastic cuts.
It is crucial to understand that this new burden placed upon the Illinois tax payer is in addition to the already unpaid Medicaid bills piling up in Illinois after lawmakers enacted a budget pushing $2.4 Billion of last year’s bills into this year. On January 30, 2012, the Civic Federation released its “Budget Roadmap” for the coming fiscal year. In it, they highlight the fact that state officials now believe the Medicaid program will have between $21 and $23 billion in unpaid bills by 2017.
Medicaid patients are already suffering from Illinois’ low reimbursement rates and long payment delays. Nursing homes and hospitals are running out of time and money while they wait for reimbursement. Doctors are turning away poor patients or making them wait weeks or months or even longer to receive care, just to keep their doors open.
What caused our Medicaid system to become so fiscally unsustainable? During Democrat Governor Rod Blagojevich’s Governorship, our Illinois Medicaid program was expanded far beyond simply providing health insurance for children of the poor (which was the original intent of the bi partisan Federal SCHIP bill). Blago expanded our Medicaid based state health insurance program to include 2 new programs that were designed to ‘supplement’ our “All Kids Covered”(www.allkidscovered.com) program (formerly “Kid Care”). These two new Medicaid based Entitlement programs (still in existence today) are called “Family Care”(www.familycareillinois.com) and “Mom’s & Babies” (www.allkids.com/pregnant.html). These programs go far beyond providing health insurance to children of the poor. In fact, they provide ‘free’ to nearly ‘free’ health insurance coverage for pregnant women and even the Father of a child who is enrolled on our “All Kids Covered” program. The program was also expanded to include coverage for those far beyond the existing Federal poverty levels. Adding to the rapid bankruptcy of our Illinois Medicaid program was the fact that under Blago’s Governorship, legal residency status was not required on the Illinois’ “All Kids Covered” Medicaid application. It took an investigation conducted by former Chicago Tribune reporter Dennis Byrne to determine just how many illegal aliens were enrolled on our “All Kids Covered” program. The shocking answer was 75%.
Obamacare simply repeats the same mistakes already made by our now bankrupt (and deeply in debt) Illinois Medicaid program. However, it does so, on a national level. It increases Medicaid eligibility to 15 million childless adults and another 9.5 million who are considered ‘old eligibles’. Those who were always eligible but never applied and will now be auto-enrolled. It also increases eligibility for Medicaid to incomes as high as 138% above the federal poverty level. What does this mean in dollars and cents? A report released by the Centers for Medicare and Medicaid Services shows the impact this massive expansion will have: “This expansion, together with greater participation by individuals eligible under current rules, is projected to add 14.9 million people to enrollment in 2014 and 25.9 million people by 2020—26 percent and 44 percent, respectively, compared to pre-[Obamacare] estimates.”
This means that by 2020, Medicaid enrollment will reach 85 million, or approximately one in four Americans. This level of Government dependency distorts the original purpose of the Medicaid program, which was intended to serve as a safety net for only the truly indigent.
As a result of the expansion, the report shows, Medicaid spending between 2011 and 2020 will increase under Obamacare by $619 billion. The federal government will initially pay for most of the new spending, totaling $572 billion. But the expansion will increasingly strain state budgets as well, since the federal contribution decreases rapidly leaving the state tax payer holding the bill. In fact, this massive expansion of Medicaid will bring total state Medicaid spending to $2.3 trillion through 2020. Illinois’ share will be another $10 Billion by the year 2020. Source: http://illinoispolicy.org/blog/blog.asp?ArticleSource=4660
If Illinois lawmakers want to ensure our Medicaid program is both sustainable and protects the most vulnerable, they must redesign it from the ground up in a way that meets the needs of Illinois’ unique population. The first step is transforming it from the broken fee-for-service design into a sliding-scale premium assistance program paired with health savings accounts. This would ensure the most vulnerable would have access to doctors and specialists, would be empowered to make healthy and cost-conscious health care choices and would no longer be trapped in government dependency. It worked in the state of Indiana under Governor Mitch Daniel and it can work here in Illinois as well. Read about the success of Governor Daniel’s Medicaid reforms here: http://www.forbes.com/sites/aroy/2011/11/11/obama-administration-denies-waiver-for-indianas-popular-medicaid-reform/
What can you do to stop Governor Quinn, Illinois Democrats and those Republicans who support the implementation of Obamacare in our state nearly 2 years early? You can call your Illinois state representative and let them know that Illinois needs real Medicaid reform, not higher taxes and that you oppose Governor Quinn’s “Medicaid Reforms” and that you are against him establishing a state based Obamacare health insurance exchange via Executive order. Call the statehouse switchboard at (217) 782-2000 to be connected. Look up your legislator here. Again, they could vote as early as tomorrow or Tuesday.
Also call House Minority Leader Tom Cross. He seems to be ‘flip flopping’ and is ready to ‘cut a deal’. He needs to know that you value and expect principled leadership and rigorous policy reform. His statehouse number is (217) 782-1331. If the line is busy, call his district office at (815) 254-0000.