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Austerity Bites: Defending Medicaid Against Budget Cuts

Wesley Epplin
February 18, 2015
Illinois’ Medicaid program and budget have been in the news a lot lately.  Most notably, Illinois’ new Governor, Bruce Rauner, proposed an approximately $1.5 billion in cuts to Medicaid in his budget proposal, including reinstituting parts of the 2012 “SMART” Act.  As many advocates and lawmakers have stated, cuts to Medicaid will hurt some of Illinois’ most vulnerable residents by limiting access to lifesaving healthcare, and in many cases actually end up raising health care expenditures. 

Prior to Rauner’s budget release, the Chicago Tribune published a front page story, Medicaid Expansion Cost Soars, on February 3, and an editorial, The state of this state? Critical. 

A number of advocates and stakeholders submitted letters to the editor in response to these stories, with the following being published by the Tribune.  These are useful perspectives for advocates to remember as we gear up once more to protect Medicaid from harmful cuts.
Health & Medicine likewise submitted an op-ed, which, while it was not published, we would like to share with our readers:

In response to the Tribune’s February 3, 2015 cover story, Medicaid Expansion Cost Soars, the fact that Medicaid expansion in Illinois has extended coverage to hundreds of thousands of previously uninsured residents is a great benefit to our state. Before the Affordable Care Act, many of those who have gained coverage waited until there was a health emergency before seeking care—this was more expensive for them, healthcare systems, and the State. Lack of coverage is not only a hardship to individuals and families (resulting in unnecessary illness, pain, loss of productivity, financial costs, stress, and tragically unjust and avoidable loss of life), but also for the hospitals and the public and private funders who bore the burden of paying for charity care. Hundreds of thousands of Illinoisans have gained health insurance and healthcare access, and we now have a far better way to pay for it; the Federal Government pays the vast majority of Medicaid expansion costs, currently at 100%, and to be reduced to 90% by 2020. Further, as more people seek primary and preventive care, we will see improvements in health and slowed growth of healthcare costs. Therefore, it is in everyone’s best interest for Illinois to figure out a way to continue to fund its portion of Medicaid. Elected officials interested in reducing Medicaid costs should also continue with other important reforms: ensuring that there are adequate reimbursement levels to provide high-quality care and services; implementing health reform and public health promotion efforts; committing to the elimination of poverty in Illinois; and facilitating healthcare access to the hundreds of thousands of Illinoisans who remain uninsured. Commitment to these reforms will ultimately save public dollars and lives.

Margie Schaps, MPH, Executive Director
Wesley Epplin, MPH, Policy Analyst
Health & Medicine Policy Research Group


As always, Health & Medicine remains committed to assuring access to the human right to healthcare.  Medicaid is a crucial part of our State’s health safety net and improving delivery systems—not cuts to the system—will make Medicaid more efficient and improve the public’s health.  As we stated in our letter, politicians who are concerned with reducing the number of people who need Medicaid should focus resources on eliminating poverty, not limiting healthcare.

Also, elected leaders must put forth plans that provide adequate revenue for the State.  There are several policy options that can be employed to gain the revenue the State needs to provide for the healthcare, social services, education, and infrastructure needs of its residents.  Illinois cannot cut its way to a balanced budget.

Advocates who are interested in being involved in advocacy to help protect Medicaid can register for an upcoming Medicaid and Budget Advocacy Summit, coming up on Friday, March 6, by clicking here. Additionally, a “Medicaid – No Cuts” resolution was introduced by Representative Mary Flowers in the Illinois House of Representatives today.