ObamaCare disaster: Why Cook County waiver fails taxpayers

Jonathan Ingram

Director of Research at Foundation for Government Accountability. Lawyer. Libertarian.

Jonathan Ingram
May 24, 2012

ObamaCare disaster: Why Cook County waiver fails taxpayers

Lawmakers have been tasked with reducing Medicaid spending by $2.7 billion. Last year, lawmakers came together and decided – almost unanimously – that until the state could actually operate the program in a way that served the needs of the most vulnerable, it shouldn’t expand eligibility to overload the system. But earlier this year, Gov....

Lawmakers have been tasked with reducing Medicaid spending by $2.7 billion. Last year, lawmakers came together and decided – almost unanimously – that until the state could actually operate the program in a way that served the needs of the most vulnerable, it shouldn’t expand eligibility to overload the system.

But earlier this year, Gov. Quinn filed a waiver request with the federal government to permit him to implement ObamaCare’s massive Medicaid expansion in Cook County nearly two years early. That waiver estimates expanding the program to an additional 250,000 people.

Given the problems facing the Medicaid program, and the near unanimous decision to stop expanding the program until it was actually fixed, it is alarming that a major component of the total Medicaid reform package being discussed is to permit the Governor to move forward with early implementation of ObamaCare. The early implementation of ObamaCare does not save any money for the Medicaid program. To include provisions that would overload an already-broken system with hundreds of thousands of new people is unwise.

While some people are urging the state to implement ObamaCare’s Medicaid expansion early, the reasons are based on myths, not facts.

Myth: Implementing ObamaCare in Cook County two years early will not cost taxpayers more money.

Fact: This plan will lead to a higher tax burden on Illinois families. One key component of this plan is to capture federal matching dollars on new Medicaid spending. Matching federal funds are paid for with federal tax dollars. Increasing federal spending at a time of record deficits and debt will only place greater a tax burden on the Illinois families paying those taxes.

Myth: Cook County taxpayers are already paying the cost to provide services to these people through uncompensated care.

Fact: Cook County taxpayers will likely see their tax burden increase. Uncompensated care costs are lower than the cost to provide Medicaid services. According to federal data, the people targeted by this plan cost an average of $742 per year in uncompensated care. In contrast, the waiver predicts these people will use more than $2,300 of health services per year. Even with a federal match, the costs associated with adding these people to the Medicaid rolls exceeds the cost currently borne by providers.

Myth: Other states, like Connecticut and New Jersey, are implementing ObamaCare’s Medicaid expansion early.

Fact: Those states already covered the expansion population. While a few states have sought waivers to capture federal money, the covered “expansion population” were already eligible in those states and paid for with state-only money. In contrast, Illinois would add 250,000 people to the Medicaid rolls who are not otherwise eligible. Additionally, a majority of states are suing the federal government over ObamaCare’s Medicaid expansion.

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