Eaton: County looks to early help from Obamacare
By Fran Eaton February 7, 2012 10:56PM
Updated: March 9, 2012 8:16AM
Cook County wants help from the feds to pay for health care the county provided to the uninsured last year.
County officials hope to get funding by jump-starting the county’s connection with the nationalized health care plan set to go into effect in two years. That would mean an immediate expansion of the Affordable Health Care Act (also known as Obamacare) to roughly 100,000 childless, low-income county residents.
Illinois now provides government health insurance for all children without private coverage as well as their parents with incomes up to 185 percent of the federal poverty level. The state also provides health care for adults 18 through 65 who are disabled.
But if you’re childless, not disabled and above the poverty level, you’re on your own or without insurance at all.
If the federal government responds positively to Cook County’s request, the feds will pay half of the health care cost for uninsured Cook County residents who do not have children or surpass 133 percent of the poverty level.
The city of Chicago has the state’s highest concentration of Medicaid recipients at 28 percent. Another 100,000 would make Medicaid coverage much more prevalent in the state’s most populous county.
But Cook County has to not only get the federal government’s approval to start this coverage, it will need state lawmakers to get on board.
Last year, the General Assembly placed a moratorium on any Medicaid expansion because the state is nearly $8 billion behind in reimbursing health care providers. And with Medicaid changes coming, Illinois’ health care debt could reach a breathtaking $31 billion by 2017, according to the Civic Federation, a Chicago-based government research group.
But the waiver Cook County is seeking could mean millions in federal tax dollars to cover the nearly $150 million in patient fees the county expected but did not get last year.
When asked about the letter that Julie Hamos, director of the Illinois Department of Health Care and Family Services, wrote to the feds at Cook County’s request, department spokesman Mike Claffey asked me to “please be objective when you’re writing about this.”
Claffey noted the negative coverage in downstate papers regarding Hamos’ request and what it would mean to taxpayers outside Cook County. He said every taxpayer in Illinois benefits when the feds subsidize a need with grants and waivers, and “if other counties want similar assistance, they would need to put in a request.”
Indeed, the need for help is clear. Cook County has to pay its bills, and health care is one of the biggest. But along with all that “free” federal money comes strings and weighty mandates. Moving Cook County into the guidelines of Obamacare could be premature at best.
Next month, the Affordable Health Care Act’s individual mandate will go before the U.S. Supreme Court in a lawsuit by 26 attorneys general, challenging the law’s requirement that all citizens must purchase health insurance or pay a fine. Those opposed to that rule say it violates the U.S. Constitution’s Commerce Clause.
That health insurance mandate is not popular among Americans. A recent poll found the public more than twice as likely to have an unfavorable view, by 67 percent to 30 percent. Of those responding, 54 percent say the mandate is unconstitutional, and 55 percent say they expect the justices to find it to be unconstitutional.
What if the Supreme Court finds it unconstitutional? Would that lead to the demise of the law and leave the cost of this expanded Cook County program on the backs of county taxpayers?
Also, would the egregious Obamacare requirement usurping religious freedom be applied immediately with this waiver? Catholics and evangelicals are upset about the law’s requirement that church-affiliated groups provide insurance coverage for birth control, even though it blatantly collides with religious doctrine. Will this transition into government-directed health care sweep away fundamental constitutional rights to exercise religion?
In government, moving quickly to solve a short-term problem may provide a false impression that things are fixed, when often bigger problems are brewing. That may be the case with Cook County and this oh-so-easy Affordable Health Care Act fix.
Hope that analysis was objective enough for Mr. Claffey.
Fran Eaton is a Southland resident who co-founded and edits the conservative political blog, illinoisreview.com