Report: Nearly 30 percent on Medicaid risk losing coverage under proposed cuts
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As Congress continues to threaten deep cuts to the Medicaid program, a new KFF report shows how some of the proposed changes could end coverage for an estimated 20 million people nationwide, more than 800,000 in Illinois. One idea targets the Medicaid expansion federal match rate. The federal government currently pays 90 percent of the costs for people covered under what's known as the Medicaid expansion, that extended coverage to nearly all low-income adults.
Liz Williams, senior policy analyst with KFF, explained that if the federal match rate drops, Illinois would have two options: come up with more than $40 billion to cover expansion costs or drop it altogether.
"Illinois has a law where the state is required to automatically end expansion coverage if the match rate drops, so in those trigger law states, there's 12 of them, enrollees are at greater risk of losing coverage," she explained.
Nearly 30 percent of Medicaid enrollees in Illinois have health-care coverage because of the Medicaid expansion and would be at risk of losing it should these changes go through.
The Medicaid expansion under the Affordable Care Act was enacted to reduce the number of uninsured people nationwide. It provided states with an increased federal match rate to help pay for their health-care costs. Williams added that if states can't afford to pick up the added costs from decreased federal support, the number of uninsured people will dramatically increase, and any gains in financial security and health outcomes associated with the expansion would be reversed.
"Medicaid is jointly funded by states and the federal government, so any restrictions in federal Medicaid spending really leaves states with tough choices about how to offset reductions," she continued.
She said states have a few options, including increasing state tax revenues, decreasing spending on non-Medicaid services such as education, or decreasing coverage for other groups. Governor J.B. Pritzker has already proposed eliminating Medicaid coverage for non-citizen adults aged 42 to 65 as a way to make up for the state's $1.7 billion-budget gap.
