Editorial: Repeal of ACA, Medicaid cuts would hurt entire state

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If Congress repeals the Affordable Care Act and reduces funding for Medicaid, the poor and sick of Illinois will be be harmed. And so will our whole community.

Congress is looking at repealing the ACA and converting Medicaid to a block grant program that would get much less federal money. House Republicans have suggested cutting Medicaid by $1 trillion over 10 years.

If that happens, even Illinois residents who get health insurance without Medicaid or the ACA will lose Obamacare reforms that have benefited everyone, such as the elimination of lifetime insurance caps. And they, along with the rest of the state, will find themselves paying a price in other unexpected ways.

For the sake of Illinois, everybody from Gov. Bruce Rauner to Cook County Board President Toni Preckwinkle is urging the Trump administration and Congress to tread lightly — first do no harm. Our own view, shared by Preckwinkle, is that to strive to improve the ACA makes perfect sense; but to repeal it at this late date would be utterly irresponsible.

• Follow @csteditorialsHospitals and other health-care providers would struggle, making it harder to maintain their quality of services for every patient. Congress imposed cuts on Medicare and Medicaid to help pay for the ACA, but that was offset by a reduction in the number of uninsured patients coming through hospital doors. If the ACA is repealed and Medicaid is cut, the number of uninsured patients would go back up. Forty-one percent of Illinois’ hospitals operate on slim or negative margins, according to the Illinois Hospital Association, and most hospitals are the biggest employer in their ward, neighborhood or town. Across the state, hospitals and health systems employ more than 260,000 people. If they are forced to lay off employees, the entire local economy will suffer. Springfield, with no budget and sinking into billions of dollars of red ink, is in no position to help.

• Cook County residents would face higher taxes or reduced services if the county’s Health and Hospitals System has to take on a new wave of uninsured patients. Before the ACA was passed, the county spent about $400 million a year on the Health and Hospitals System. That’s been reduced to $111 million now that many more patients have health insurance. On Tuesday, Preckwinkle and local by health care professionals held a press conference urging Congress not to repeal the ACA.
• Increased access to health care can prevent epidemics that put everyone at risk. In 2015, Indiana officials stopped a rash of HIV infections in the rural southern part of the state by enrolling people in the ACA. One of the best protections against an unexpected epidemic that puts everyone at risk is a population with access to health care.
• Converting Medicaid to a block-grant program could lock Illinois in as the state with the lowest Medicaid reimbursements. For historical reasons, the federal government reimburses Illinois at a 50 percent rate. Every other state in the Midwest gets more, and some states get as much as 80 percent. Nationally, Illinois is at the bottom in Medicaid reimbursement per enrollee.
• A new report by Health Care for America Now shows repealing the Affordable Care Act would cost more than a million Illinoisans their health coverage. According to the report, someone would have to pay for $1.2 billion worth of uncompensated care; 114,000 people would lose their jobs, and hospitals and physicians would lose $2.7 billion of income.
• The re-opened Medicare “donut hole,” closed as part of the ACA, would cost Illinois seniors and people with disabilities an average $1,041 a year more for drug costs, according to an estimate by Families USA.
• The federal government gives Illinois get more than $3 billion a year for Medicaid. To deal significant Medicaid cuts, the state would have to dump people from the Medicaid rolls, make it harder to get Medicaid, slash the reimbursement rates to health care providers or significantly reduce what kinds of of services are covered. In Illinois, 3.2 million people have Medicaid, almost a quarter of the state’s population, according to a Jan. 17 letter Illinois Acting Director of Insurance Jennifer Hammer wrote to congressional leaders asking them to “carefully consider the ramifications of proposed changes.”

As the debate over the ACA and Medicaid continues in Washington, everyone in Illinois should understand they have a stake in the outcome. More than ever, repair sure looks better than repeal.

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