Expansions to Medicaid because of the Affordable Care Act and COVID-19 have increased the program in Illinois as Congress considers potential cuts or work requirements.

Medicaid is one of Illinois government’s largest and fastest-growing expenses, accounting for more than 28 percent of the state’s total operating budget.1 It has also been a prime target of waste, fraud and abuse, earning a “high risk” designation from the U.S. Government Accountability Office.2 Most states, including Illinois, have focused fraud-prevention efforts on provider...

Illinois’ Medicaid program should be transformed into a sliding-scale premium-assistance program that targets resources to those who need them most.