What court's Affordable Care Act rulings mean for Illinois

What court's Affordable Care Act rulings mean for Illinois
Creative Commons image courtesy of TruthOut.org

More low-income people in Illinois will be able to enroll in Medicaid, and the state could create its own exchange for Illinoisans to shop for competitively priced health insurance, following the U.S. Supreme Court's decision today to uphold most of President Barack Obama's signature health care law.

When it comes to Medicaid, the majority of the Supreme Court justices ruled that states could decide whether to expand their Medicaid coverage.

States that do so are eligible for increased federal funding. But the justices struck down part of the law that would have forced states to expand Medicaid or lose all funding. States that do not grow their Medicaid rolls could, in effect, reduce coverage for some of the neediest.

But what does the ruling mean for Illinois and local government?

Earlier this month, Gov. Pat Quinn signed into law HB5007, which allows the Cook County Health and Hospitals System to immediately increase Medicaid eligibility for 100,000 county patients and pay for it with increased federal funding.

That money would come in the form of a direct federal waiver--known as a 1115 Waiver--which still has to be approved by the U.S. Department of Health and Human Services, said Lynda DeLaforgue, co-director of Citizen Action/Illinois, a non-profit that supported the Affordable Care Act.

In short, DeLaforgue said, the county can continue to treat needy people who are already being cared for, but actually receive reimbursement for the care--in a lot of cases, the county has gotten stuck with bills--at no cost to the state, since those people will now be eligible for Medicaid.

Had the Affordable Care Act been struck down, the county would not have been able to receive any of the money.

This would have dealt a serious blow to the cash-strapped county, which directs roughly three-quarters of its annual budget to the health, hospitals, and criminal justice systems.

Yesterday, Cook County Board President Toni Preckwinkle announced there will likely be a $267.5 million deficit in next year's budget. She added that, if the Affordable Care Act was not upheld, CCHHS would have seen a $152 million hole in its budget.

"I applaud today’s decision by the U.S. Supreme Court upholding the Affordable Care Act," Preckwinkle said, in a statement. "This waiver, if approved by the federal government, would permit CCHHS to receive federal reimbursement for the costs of treatment provided to the tens of thousands of our patients who currently have no medical coverage but will gain access to Medicaid on Jan. 1, 2014."

David Gaudette, an organizing director at Citizen Action/Illinois, pointed out that additional Medicaid funding for the state could offset some of the $1.6 billion in Medicaid cuts that came out of Springfield this spring.

"This shines a new light on our ability to protect those who are at greatest risk; it's a new day," Gaudette said.

He also said that state lawmakers need to begin being thinking about how they'll pass legislation to create a state-run health exchange--something that went nowhere in the spring session.

The Affordable Care Act requires states to create a health exchange--essentially, a Web-based marketplace for consumers to shop for competitively priced insurance--or have the federal government create one for them. Federal funds are also available for states that do so, and Illinois has already received millions to put toward the project--if the legislature ever gets around to doing so.

Quinn--who supports the Affordable Care Act, and is "thrilled" it was upheld, wanted state lawmakers to create the exchange this past session. He even threatened to issue an executive order to create one, but he didn't end up delivering on that threat.

The governor is also reportedly interested in a federal-state partnership in which the federal government would be responsible for the technology side of the exchange, while the state would be tasked with handling enrollment and beneficiary management.

The Chicago Reporter contacted Brooke Anderson, a Quinn spokeswoman, to see where the governor is at on the issue, but she did not return two calls.

The Illinois Chamber of Commerce, which opposed the Affordable Care Act, issued a press release today stating that it supported the idea of moving forward with state legislation that would create an exchange.

"The Supreme Court's decision allows employers, consumers, and states to resume planning and implementation efforts with greater certainty, but we also know the enormity of this law presents ongoing challenges and questions for the employer community that we look forward to working with state and federal lawmakers to address."

Other business groups around the country--many of which oppose the law because of higher costs and penalties for not insuring employees--were not nearly as conciliatory.

Quinn did sign legislation today at the newly opened Ann and Robert H. Lurie Hospital in Chicago that will allow small business owners to pool their resources and form a Healthcare Purchasing Group. They will be able buy insurance for up to 2,500 employees, through the group.

© Community Renewal Society 2012

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