With sharp Medicaid cuts that could kick in automatically and half a billion dollars less in the revenue forecast than initially expected for the coming fiscal year, Illinois is in no position to make up for any of the federal funding shortfalls on its own.
The Governor’s Office of Management & Budget said yesterday it expects $54.9 billion in revenue for the fiscal year beginning July 1, while its previous forecast called for $55.5 billion.
During the current fiscal year through April, federal sources of funding, mainly reimbursements for state Medicaid and Medicaid waiver spending, were behind $278 million and the shortfall is not expected to be made up in the fiscal year, the budget office report said.
Looming cuts to Medicaid are much greater, with the federal Congressional Budget Office projecting this week that some 8.6 million Americans could lose Medicaid coverage in the coming decade with at least another 5.1 million losing expanded Affordable Care Act Medicaid coverage due to new restrictions, including work requirements.
An Urban Institute report released today found between 225,000 and 257,000 adults in Illinois with expanded Medicaid coverage could lose that coverage in 2026 if Congress enacts a work requirement for adults under the age of 65. The Robert Wood Johnson Foundation-funded report paints an even bleaker picture than the Congressional budget office, saying more than 6 million are in jeopardy of losing coverage nationwide.
In the 41 states, including Illinois, that expanded Medicaid through the ACA, coverage would recede even though 89% of the people enrolled in Medicaid expansion already work or could meet exemption criteria like being a family caregiver, the Urban Institute said.
“Federal lawmakers seem ready to advance a policy that has been proven to be ineffective, costly and damaging to millions of working families," Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, said in a release. “Medicaid work requirements don’t work. They don’t promote employment, and they take coverage away from people who don’t have other options. The ripple effects of enacting federal work requirements will be felt across local health care systems and economies for years.”
In addition to expanded Medicaid coverage losses, Illinois is considering ending its Medicaid-like aid to immigrants.
Pritzker launched the HBIA and HBIS programs in recent years, but enrollment was much greater than expected and costs ballooned.
California Gov. Gavin Newsom today announced the state’s own, similar health care program for undocumented immigrants might no longer be free to enrollees.
In an attempt to fight the billions in cuts, activists with Citizen Action/Illinois plan to hold a vigil on May 15 outside the Normal offices of Republican state Rep. Ray LaHood, asking him to vote against his party’s wishes to protect Medicaid, Medicare, SNAP benefits.
LaHood’s office did not respond to a request for comment from Crain’s.
Illinois Rep. Robin Kelly said today she offered up two amendments to the GOP budget plan that would protect Medicaid and "reduce waste, fraud and abuse."
But, "to no one’s surprise, Republicans voted them down," she said in a statement.
Rep. Raja Krishnamoorti said in a recent interview with Crain’s that the $880 billion cuts to Medicaid were "draconian" and imperil people’s lives.
Krishnamoorthi said fighting the GOP majority would take constant opposition, as well as appealing to Republican representatives to protect Medicaid and to those representatives’ constituents.
He said that his fight was personal, as well as political, as he grew up relying on public programs like SNAP and public housing.
