Rearranging the waiting room chairs
Monique Garcia of the Chicago Tribune reports that the Illinois Senate voted 58-0 to enact a series of reforms to the state Medicaid system. As the vote indicates, the reforms are hard to argue with. Unfortunately, as I’ve reported, they do very little to resolve the state’s Medicaid financing crisis — a crisis that can only be solved through some combination of drastic cuts in Medicaid, major state tax increases, and greater federal assistance to Illinois, which unlike the federal government, must balance its budget.
Most of the reforms boil down to good-government and anti-fraud measures such as ensuring that people who receive Medicaid are actually who they say they are and qualify for the program. The state does plan to reduce eligibility for the AllKids health care program from literally all kids in Illinois to those at no more than 300 percent above the poverty level, which means a $66,000 annual income for a family of four. But these changes will, at most, subract a few hundred million dollars from a Medicaid budget that will cost the state $6.8 billion in fiscal-year 2011.
The fate of the state’s Medicaid program between now and 2014, when national health care reform will dramatically increase federal financial support, is tied to much bigger political choices: Namely, whether any additional federal assistance is forthcoming and whether Gov. Pat Quinn and the state legislature can work out a solution to the state’s $15 billion budget deficit. Quinn’s most recent proposal is a $15-billion bond to pay off the deficit plus a tax increase to pay off the interest on the bond. Wise or not, Quinn’s proposal is suitably dramatic for an unprecedented state fiscal crisis — one where Illinois will probably continue to fail to pay health care service providers.
