Gov. JB Pritzker recently issued emergency rules to limit the scope of a state program to provide Medicaid-like health coverage to those not eligible for Federal Medicaid reimbursement because they are undocumented or have a green card and haven’t satisfied the five-year residency requirement.
The sponsor of the bill that established the program initially touted the cost at $2 million per year, but it has ballooned to an estimated $1.1 billion per year. Implementation of the program was delayed until January so half of the $1.1 billion would fall into the next fiscal year. Still, that wasn’t enough to keep it from blowing up this year’s budget.
The emergency rules seek to limit the cost of the program with the following:
• A temporary enrollment pause. When the new fiscal year begins July 1, new eligible residents ages 42 to 64 won’t be able to sign up.
• The state will cap at 16,500 the number of senior citizens who can enroll.
• Everyone enrolled will have to start paying copays of $100 to $250 for hospital visits that are not eligible for matching federal reimbursement.
No sooner had Pritzker issued the rules than the condemnations started.
From a story on the WTTW website, Tovia Siegel, director of the Healthy Illinois Campaign, said the qualifiers are “rooted in bias and were made without consultation of advocates.”
No, they’re not. The original plan extending coverage to those over age 65 was passed in the 101st General Assembly as part of the Budget Implementation Act (BIMP) without discussion or debate. It was expanded to those ages 55 to 64 in the BIMP passed in the 102nd General Assembly, again without discussion or debate. Finally, it was expanded to those from age 42 to 54 by Public Act 102-1037.
All told, the administration’s estimate of costs for the three programs combined was $210 million to $260 million per year, a far cry from the sponsor’s initial estimate, but still far short of reality. Those estimates had to come from somewhere, and they certainly did not come from testimony in committee. They most likely came from consultation with the same advocates mentioned above who knew that if an honest estimate of future enrollment was disclosed, these bills would never have seen the light of day.
All the players here know their roles and are playing them quite well because you can’t tell me they didn’t see the writing on the wall long before these rules were issued.
Somewhere along the line, the two sides will come to some sort of accommodation which will give that constituency more of what it wants, and since the bill conveniently waived the 24-month limitation on issuing new emergency rules on a similar subject, the governor will be able to do it immediately.
From an administrative standpoint, it’s really no different from his issuance of 40-some consecutive disaster declarations stemming from COVID-19, but it will be under the authority of administrative rule and not in the light that comes from full debate and a vote by the General Assembly. We’ve seen this movie before, and it’s not going to end well.
• State Rep. Steve Reick represents Illinois House District 63 based in Woodstock. He can be reaches at sereick@gmail.com or reick@ilhousegop.org.