The General Assembly has overwhelmingly approved steep cuts to Medicaid, Illinois’ system of health care for the poor. Backers of the cuts say they’re a long-overdue correction for a program that’s grown out of control. But others — including many African-American lawmakers — say the state shouldn’t balance its budget on the backs of its most vulnerable citizens. Brian Mackey has our story:
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The day began with reports that talks on reductions to Medicaid had come to an impasse. Senate Republicans were said to have concerns with the proposal, and members of the Black Caucus were going to fight the cuts.
But by late afternoon, legislation sailed through the House and Senate in just a few hours. It had broad support from both Republicans and Democrats.
Senator Heather Steans, a Democrat from Chicago, sponsored the proposal.
STEANS: “It’s really in total about shared sacrifice, and making a lot of tough decisions here for the overall good of the state.”
Taken together, those decisions slash about one-and-a-half billion dollars in health care spending for the poor. A small portion of that comes from reducing the amount of money the state pays to hospitals, nursing homes, and other providers.
But most of the savings comes from taking away services and shrinking the number of people eligible for help. For example, it limits the number of eyeglasses people can get, ends prescription drug assistance for seniors, and no longer pays for visits to the chiropractor or podiatrist.
It also requires the state to take a hard look at people on the Medicaid rolls to make sure they truly qualify.
Plenty of groups oppose the cuts. At a hearing before a House committee, a parade of activists tried to convince legislators that cuts to their clients’ programs would be disastrous.
“One dentist can three-thousand patients in a year at a clinic. This will eliminate that safety net.” … “The alternative for children in this program … is permanent hospitalization.” … “We are struggling, and I hesitate to guess that there will be a number of facilities closing.” … “My client is concerned that this will possibly increase the number of elderly divorces.” … “Particularly egregious to us is zeroing out the Illinois Cares RX program, the prescription program, away from seniors.”
[Voices of Dave Marsh, Illinois State Dental Society; Cheryl Jansen, Equip for Equality; Dean Sweitzer, Lexington Health Care Network; Katie Anselment, Illinois Chapter of the National Academy of Elder Law Attorneys; and William McNary, Citizen Action/Illinois.]
That last voice was William McNary, with Citizen Action Illinois — a self-described progressive advocacy group. The consensus in the Capitol seems to be that cutting Medicaid is good politics. But McNary hit on one of the biggest policy questions: What will be the unintended consequences?
McNARY: “People will not get less sick because we make these cuts. As a matter of fact, in many cases it’s going to drive up health care costs over time because some of the people who would seek preventive care will now seek after-the-fact care.”
Case in point: adult dental care is being cut — except for emergency cases that require pulling teeth. But dentists say tooth extraction is a job for oral surgeons, and most of them don’t take Medicaid patients. So people will wait until toothaches become infections that leach into the brain and require long, expensive hospital visits. And every advocacy group has stories like that.
It was enough to make many African-American lawmakers argue forcefully against the cuts. Donne Trotter is a Democrat from Chicago and one of the longest-serving state senators.
TROTTER: “I have never seen the callousness that is existing with individuals who want to take such a drastic cut against those who basically are the most vulnerable.”
Sen. James Meeks, another Chicago Democrat — and the pastor of a Baptist church — framed the cuts as a social-justice issue. He called the proposal a “moral disgrace.”
MEEKS: “Are there people, who really need these services, that once we push that green light, are we pushing people into the grave?”
MURPHY: “The point has been made that this is immoral. This is not immoral.”
Matt Murphy is a Republican senator from Palatine. He acknowledged that people would be hurt by the cuts.
MURPHY: “But what would be immoral, in my mind, would be to sit back, pretend there’s no problem, let thing roll on, build up more of a backlog of bills — to the point where the entire Medicaid system collapsed.”
The legislation now goes to Governor Pat Quinn, who has pushed for Medicaid cuts for months.
But it’s just one piece of a broader package that intends to transform the Medicaid system.
Another complex component also headed to the governor’s desk would allow Cook County to grab more federal money by actually signing up new Medicaid patients. County officials say it will cost the state nothing and actually save the county money in the long run.
Lawmakers are also likely to consider a dollar-a-pack tax hike on cigarettes — and possibly other tobacco products. They have less than a week remaining until they are scheduled to adjourn for the summer.
I’m Brian Mackey.