The State Budget Aftermath - What's Next?

On May 25, 2012, the Illinois legislature voted to pass Senate Bill 2840, which will make drastic cuts to the state’s Medicaid program, in order to help close a $2.7 billion deficit. The news has been confusing, but the bottom line is that many of the programs which provide necessary health coverage to vulnerable populations of Illinoisans have been terminated or reduced, which will result in thousands of people losing health care coverage.

While those cuts are devastating, we remind ourselves that there are over 2 million people covered by Medicaid in Illinois—many of them covered through important expansions including the 100% Campaign, All Kids, Health Benefits with Disabilities, and FamilyCare. These coverage expansions largely remain intact and protected. We are heartened by the fact that our advocacy efforts, along with our colleagues, also staved off worse proposed cuts including the loss of coverage for tens of thousands of undocumented children with no health care alternatives.

Along with Senate Bill 2840, several other bills were passed which also affect Illinois’ Medicaid program including:

• HB5007: Amends the December 2010 Medicaid reform law that placed a moratorium on Medicaid expansions until 2013. This amendment extends that moratorium for two more years, until January 25, 2015. However, the bill also creates an exception for expansions that are federally approved and funded solely by federal and local government funds. This exemption was specifically designed to allow the Cook County 1115 waiver proposal (currently waiting for approval from CMS) to move forward, which would expand Medicaid to 250,000 low income, currently uninsured Cook County residents.
• SB 2194: Limits the number of unpaid Medicaid bills that can be rolled over from one year to the next, capping the dollar amount at $700 million in FY 2013. SB 2194, HA 3 sets more substantial definitions of charity care, so that hospitals will know what services they can provide to meet that definition, and thus retain tax exempt status 
• SB 3261 HA 2: Sets standards for eligibility for free care at non-profit hospitals

Moving forward toward the implementation of health care reform in 2014, Health & Disability Advocates will continue working to ameliorate the effect of these cuts by counseling individuals on their coverage options and training providers to build their capacity to help their patients access alternative coverage. There is not a solution to every cut but, in many instances, there are alternative programs to get necessary health care coverage to our populations.

We think it is important that while we all continue to fight against these cuts, we must immediately spring into action to help individuals transition to other coverage if at all possible.

For example, the elimination of the Illinois Cares Rx program is expected to affect over 100,000 low income older adults and people with disabilities who use the program to help them pay the premiums, deductibles, and cost-sharing of the Medicare Part program. If you or your clients have Illinois Cares Rx stories to share, please have them submit them to a special Facebook page here.

We have scheduled a webinar for June 15th to train providers how to ensure that their clients and patients use past medical bills to meet Medicaid spenddown, thus making them eligible for the federal Extra Help program which will cover all cost-sharing. We expect that tens of thousands of Illinois Cares Rx recipients could become eligible for Extra Help under this strategy.

We will continue to advocate as well as to move forward by counseling individuals, training providers and providing technical assistance to our partners to ensure that we maximize health care coverage and access in every way possible.

Stephanie Altman
Programs & Policy Director
Health & Disability Advocates