Making Medicaid work for Illinois

Making Medicaid work for Illinois

Full-time workers make up less than one-third of Illinois’ Medicaid rolls.

The ultimate goal of any welfare program should be to put its participants on the path to a better life. But one of Illinois’ largest and fastest-growing welfare programs is failing miserably at this goal, according to data from the U.S. Census Bureau.

Medicaid accounts for nearly 30 percent of the state’s operating budget. Unfortunately, it has trapped more than one-third of its participants in dependency.


Fewer than one-third of all able-bodied, working-age adults receiving Medicaid in Illinois are working full-time, year-round jobs. Another 31 percent work part-time, seasonally or for only part of the year, while a whopping 36 percent of enrollees don’t work at all.

These are adults in their prime working years who have no disabilities keeping them from meaningful employment. What they need most are jobs, not welfare benefits that trap them in poverty. Full-time work would bring many of these families out of poverty altogether.

To be certain, part of the problem is caused by the state’s anemic economic growth. Illinoisans are giving up on finding work en masse. But Illinois’ welfare system also contains perverse dependency traps that keep families poor and rob them of a better life. This distorted design unfairly punishes families for working more hours, finding a better-paying job or looking for work in the first place. When a few extra dollars can mean losing thousands of dollars in benefits, it’s no wonder so many have gotten stuck.

Illinois’ Medicaid program will remain in poor health until reform efforts are directed to what’s ailing it. For the sake of the state’s ability to provide benefits to those truly in need, policymakers must take seriously the fact that so many participants in Illinois’ most costly welfare program are not working.

State lawmakers should start by passing pro-growth reforms in a state home to the worst recession recovery in the nation, making finding work easier for people across the state. Lawmakers should then seek greater flexibility to incorporate the kinds of work requirements in Medicaid that made the 1990s welfare reform so successful.

In the meantime, Illinoisans are in desperate need of a top-to-bottom evaluation of the state’s complex and often duplicative welfare system. Only then can policymakers move toward demolishing the welfare cliff, which makes it less financially viable to move up the income ladder, punishes struggling families and shrinks the state economy.

The future of government programs that give a leg up to those in need depend on tough decisions like these from Illinois lawmakers.

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