Illinois’ future under ObamaCare

On Monday, the Supreme Court will begin 3 days of oral arguments on the constitutionality of ObamaCare. The case pits the Obama administration against 26 states, and could be one of the biggest federalism showdowns the Court has seen in years. The case centers primarily around two key components of the law: the individual mandate and the...

On Monday, the Supreme Court will begin 3 days of oral arguments on the constitutionality of ObamaCare. The case pits the Obama administration against 26 states, and could be one of the biggest federalism showdowns the Court has seen in years.

The case centers primarily around two key components of the law: the individual mandate and the Medicaid expansion. The individual mandate requires that everyone purchase government-approved health insurance or enroll in public insurance programs like Medicaid. Under the law, if you choose a plan that isn’t approved by federal bureaucrats or choose to pay for medical care out-of-pocket, you pay a fine to the IRS.

The law also requires states to expand Medicaid eligibility to cover millions of new enrollees. Together, these two provisions are expected to put one in three Illinoisans on the Medicaid rolls. Sadly, Illinois has already seen what this kind of expansion does. The state spent the better part of a decade expanding Medicaid to more and more previously-ineligible people. Today, the program is twice the size it was in 2000.

The result? Worsening access and care for the very people Medicaid was meant to protect. The state is six-months behind on paying the billions of dollars it owes to doctors and hospitals that treat Medicaid patients. Even when they do get paid, the reimbursement rates are often below the actual cost to treat patients. It’s no wonder that more and more doctors are putting up signs in their windows saying they don’t take Medicaid patients.

Ultimately, the poorest are hurt worst by this. They’re forced to compete with more and more people for the few doctors willing to see them. In Chicago, children diagnosed with juvenile diabetes wait over three months just to see a specialist when they’re on Medicaid, if they can get an appointment at all. Half of them will be turned away.

ObamaCare only makes these problems worse. It expands the program to millions of new people and leaves the very poor, the people Medicaid is supposed to protect, with nowhere else to turn. There is a better way. Real reform repeals the one-size-fits-all approach and gives states the flexibility they need to design health care programs for their poorest citizens.

The Institute has offered innovative reforms for creating a program that actually protects the most vulnerable. Our reforms would transform Medicaid into a program that helps the poor buy private health insurance, empowering them to select health plans that meet their own needs, instead of the needs of bureaucrats in Washington or Springfield. These plans would be paired with health savings accounts, encouraging enrollees to engage in cost-conscious and healthy behaviors. This would give the poor meaningful choices and greater control over their health care. Best of all, this would give the poor real access to necessary care. They would receive the same care as everyone else. When they walk through the door of the doctor’s office, they would be treated with dignity and respect. They’d no longer be segregated into inferior care.

By phasing out this help gradually as the enrollee climbs up the income ladder, states can avoid trapping the poor into a system of government dependency. The working poor would no longer face steep penalties for improving their lives. Instead, subsidies would be phased out slowly, with enrollees being asked to pay for more of their health care needs as their incomes rise.

We’ve seen what the foundations of ObamaCare can do. It’s not just bad law. It’s bad policy.