Illinois should shun ObamaCare and pursue Rhode Island-style Medicaid reforms

In a recent interview to commemorate the 50th anniversary of Martin Luther King Jr.’s March on Washington, President Barack Obama managed to plug the ObamaCare program by encouraging people to sign up for coverage on a government website. Few can disagree with the goal of affordable health care coverage, especially for the medically needy and poor. While...

In a recent interview to commemorate the 50th anniversary of Martin Luther King Jr.’s March on Washington, President Barack Obama managed to plug the ObamaCare program by encouraging people to sign up for coverage on a government website. Few can disagree with the goal of affordable health care coverage, especially for the medically needy and poor. While Obama was plugging his massive program, The Wall Street Journal was highlighting how much better Rhode Island’s approach to Medicaid reform is.

The ObamaCare model for providing coverage to the poor is based on encouraging states to expand the eligibility guidelines of their Medicaid programs. The Medicaid program has routinely failed to both control rising costs and provide better access to care.

Medicaid is an entitlement program which means that the program’s costs are based on the number of eligible individuals and not on a pre-determined budget authorization. Under the program, federal dollars are matched by state funds to provide coverage for the medically needy and the poor. Since Illinois, for example, receives about 50 cents for every 50 cents the state spends, states have had little reason to reform the program to save money.

But one state has made significant improvements to its Medicaid program.

Rhode Island’s Medicaid reform effort is a bright spot in an otherwise bureaucratic and bloated program. Rhode Island is not only saving money, but it is also doing so while delivering better care to the state’s poorest and most vulnerable citizens.

In 2011, Rhode Island requested federal permission to begin operating with fewer federal rules and requirements. The results have been impressive. According to The Wall Street Journal:

“A 2011 audit by the economic consulting firm Lewin Group concluded that reforms allowed under the waiver were ‘highly effective in controlling Medicaid costs,’ while improving ‘access to more appropriate services,’ and leading to ’lower emergency room utilization’ and ‘improved access to physician services’ for Medicaid patients with asthma, diabetes, heart problems and mental disorders.”

The article continues:

“Those savings are especially impressive because under the waiver the state is required to cover all residents eligible under federal rules, so caseloads increased each year. However, the per-recipient costs fell to $770 a month in 2012 from $813 in 2010. The annual rate of increase was 1.3% per recipient nationwide, but minus-1.1% in Rhode Island. When is the last time an entitlement program’s costs fell?”

Two major reforms in particular saved money. The first reduced costly emergency room visits by Medicaid recipients for routine medical needs, and the second reduced admissions to pricey nursing homes by offering home-care subsidies and promoting assisted living arrangements, which seniors generally prefer.”

Illinois’ Medicaid program – which was expanded by state lawmakers as a part of ObamaCare – is failingboth our state’s most vulnerable population and our taxpayers. We must do better. Illinois lawmakers should build upon the success of the Rhode Island approach to create a medical safety net in Illinois that will protect both our most vulnerable citizens and our taxpayers. Then, we can truly take our first step toward building a system that provides health care access and affordability.