Policymakers in the Land of Lincoln have some important work to do this year to preserve limited state resources for the truly vulnerable. Stopping the enrollment of able-bodied adults in Illinois’ Medicaid expansion program, and instituting work requirements for able-bodied adults in Medicaid are necessary to safeguard the program for Illinoisans most in need of services.
A Medicaid enrollment freeze waiver can preserve resources for truly needy Illinoisans
To stop Medicaid expansion enrollment, Illinois policymakers should ask the Trump administration for an enrollment freeze waiver. The program is devouring state tax dollars that could go to help Illinois’ truly needy residents, including the 18,000-plus Illinoisans on Medicaid’s Prioritization for Urgency of Need for Services waiting list. An enrollment freeze waiver would allow state officials to stop the hemorrhaging of Medicaid dollars and begin to immediately prioritize truly vulnerable Illinoisans once again.
Medicaid work requirements can prevent the safety net from becoming a poverty trap
But that’s just the beginning of what Illinois officials must do to reform the state’s overgrown and unsustainable Medicaid system. The state should also request a waiver to institute work requirements for all able-bodied adults in Medicaid. Medicaid’s safety net has become a web that traps too many Illinoisans in dependency. But with the requirements in place, the truly vulnerable and taxpayers will find much-needed relief. Equally important, enrollees will be better able to transition to self-sufficiency.
Currently, Illinois’ Medicaid program is operating as a welfare trap – a system that encourages individuals to remain in dependency indefinitely and penalizes them if they try to leave. There’s perhaps no better proof of this phenomenon than the number of Illinoisans who are in the Medicaid program and not working at all.
According to the most recent data from the U.S. Census Bureau, less than one-third of all able-bodied, working-age Medicaid enrollees in Illinois work full time. By contrast, nearly 36 percent don’t work at all.
In addition, according to data from the Department of Healthcare and Family Services, nearly 54 percent of able-bodied adult enrollees in the Medicaid expansion reported no income at all in 2015. Continue reading
Illinois’ Medicaid program has spiraled out of control. Since opting to expand Medicaid through Obamacare, the state has enrolled roughly 650,000 able-bodied adults – nearly twice as many as the state said would ever even qualify, much less enroll. Over that same period, 752 truly needy Illinoisans have died on a waiting list for medical treatment. And with a large Obamacare bill due in less than a month, policymakers should start working now to put the brakes on this nightmare.
Thankfully, simple, tested and effective policy solutions exist to the challenges facing the state. By freezing enrollment in its Medicaid expansion program, Illinois can immediately begin protecting resources for its truly vulnerable citizens and help Illinoisans currently trapped in welfare get back on the path to independence. In addition, lawmakers would immediately provide much-needed relief to overburdened state taxpayers.
Enrollment freezes are simple: Rather than pulling the plug on the expansion program overnight, the state would allow current enrollees to stay for the time being, but would stop enrolling new members. This allows lawmakers to gradually wind down the program over time, but immediately free up resources for the truly vulnerable.
This past Sunday, Arkansas State Senator Bryan King appeared on America’s News Headquarters to discuss ObamaCare expansion’s enrollment explosion:
The Illinois General Assembly opted to expand Medicaid through Obamacare in May 2013. This expansion created a new Medicaid category for able-bodied adults ages 19-64 with incomes below 138 percent of the federal poverty level.
But the Medicaid program was designed to serve the truly vulnerable – the aged, the blind and the disabled – and expansion critics have long warned that creating a new welfare class would prioritize able-bodied adults and put more vulnerable people at risk by redirecting limited resources. Now, newly obtained data from the Illinois Department of Human Services, or DHS, confirm these fears.
According to documents provided by the department, 752 Illinoisans on the state’s Medicaid waiting list have died awaiting needed care since the General Assembly voted to accept the Obamacare expansion for able-bodied adults. That’s 18 deaths each month, on average, since the expansion was authorized. Continue reading
Yesterday, The Wall Street Journal editorial page covered our ObamaCare expansion explosion report that published last week, calling the explosion itself an “embarrassment:”
In a new report this week for the Foundation for Government Accountability, Jonathan Ingram and Nicholas Horton tracked down the original enrollment projections by actuaries in 24 states that expanded and have since disclosed at least a year of data on the results. Some 11.5 million people now belong to ObamaCare’s new class of able-bodied enrollees, or 110% higher than the projections. Continue reading
Today, the Foundation for Government Accountability released a new report, authored by myself and Jonathan Ingram. We surveyed every ObamaCare expansion state, comparing enrollment projections to actual enrollment.
Here’s what we found:
Altogether, 24 states that accepted ObamaCare’s expansion released enrollment projections in advance and have since reported at least one year of enrollment data. In total, these 24 states promised that “only” 5.5 million adults would ever sign up for ObamaCare expansion. However, actual sign-ups have surpassed these projections – and not just by a little bit. Continue reading
Illinois was one of the first states in the nation to accept ObamaCare’s Medicaid expansion. But since its launch, the program has spiraled out of control, blowing through enrollment projections and putting Illinois’ most vulnerable residents at risk.
In fact, the very same day the General Assembly voted to implement ObamaCare’s Medicaid expansion two years early in Cook County, lawmakers also voted to implement cuts to traditional Medicaid, costing Jake Chalkey of Streator, Ill., access to critical seizure medication.
As enrollment continues to climb, these cuts may be a sign of what’s to come. Continue reading
On September 30, 2016, I appeared on The Paul Harrell Program to discuss the latest developments with Arkansas’ ObamaCare Medicaid expansion (27:00 mark):
In state capitols across the country, health care lobbyists and consultants are pushing a relatively unknown provision of the Affordable Care Act (ACA): Section 1332. According to some proponents, these waivers will “turbocharge state innovation” and will provide states with an “exit strategy” from the ACA. But is the hype true? Will Section 1332 waivers be as truly transformative to our health care system as suggested?
As policy practitioners who work daily with state policymakers around the country, we have seen proponents be overly dismissive—or perhaps even unaware—of the large practical and political challenges surrounding the implementation of these waivers. A serious, objective examination of the new Section 1332 federal guidance sparks far more questions than answers for policymakers. Continue reading
Arkansas’ Obamacare expansion, commonly known as the “Private Option,” has been a nightmare. Costs have run significantly over budget and the truly needy are being pushed to the back of the line. The Government Accountability Office reported that Arkansas’ approach was simply a more expensive way to expand Obamacare. And, surprise, the promised economic stimulus from expansion never materialized.
The program has proven wildly unaffordable for taxpayers and has become a political landmine for state legislators. Facing mounting cost overruns and serious questions about long-term sustainability, the legislature and governor agreed last year to terminate the expansion at the end of 2016.
But now Governor Asa Hutchinson has decided that the state desperately needs to keep Obamacare expansion and has called a special session that will begin April 6th to extend it. Hutchinson’s plan will also make cosmetic tweaks to the expansion and give the program a new, Orwellian name: “Arkansas Works.”
One of the key bugs, errr, “features” of this new plan is to begin utilizing employer-sponsored health insurance plans for Medicaid expansion enrollees. But there are several elements of this proposal that are cause for serious concern. Continue reading