Posts Tagged ‘rural’
Illinois hospitals fear massive cuts under Trump domestic policy law
Capitol News Illinois
Article summary
President Trump’s domestic policy bill contains massive cuts in federal Medicaid spending over the next 10 years.
One analysis predicts $48 billion in spending reductions in Illinois over a decade.
The cuts limit states’ ability to raise money through provider taxes to fund their share of Medicaid costs.
The cuts also limit the way states use Medicaid to direct additional payments to hospitals.
SPRINGFIELD — Hospital officials in Illinois say they will have to make some difficult decisions in the next few years that could involve laying off staff, cutting back services and even closing some facilities entirely.
That’s the expected result of federal funding cuts built into the recently passed domestic policy bill that President Donald Trump signed into law July 4, a law that will cut federal spending on Medicaid by more than $1 trillion over the next 10 years.
A.J. Wilhelmi, CEO of the Illinois Health and Hospital Association said in an interview with Capitol News Illinois that the financial pressures will fall heaviest on hospitals that serve rural areas, where a larger share of the population is covered by Medicaid.
“The hospitals in these communities are already on the brink, based on some of the increases in labor, drug and supply costs coming out of COVID, a continuation of claim denials by payers and relatively flat reimbursement rates,” Wilhelmi said. “So, all of that is creating significant pressures. And when you add these Medicaid cuts to an already challenging situation, we know that there are several hospitals that close because of these changes.”
Enrollment, reimbursement reductions
The new law contains provisions that are expected to reduce the number of people enrolled in Medicaid, particularly in states like Illinois that expanded eligibility for the program under the Affordable Care Act, the 2010 law commonly known as Obamacare.
Those include work requirements for people who enrolled through the expansion as well as requirements that they verify their continued eligibility for the program twice a year instead of annually.
But the law also includes changes in aspects of the program that most people outside the health care industry never see. Those mechanisms – known as provider taxes and directed payments – affect the way states finance their share of the cost of Medicaid and the way they direct additional payments to certain health care providers such as hospitals.
Like many states, Illinois levies special taxes on certain health care providers, including hospitals. The money those taxes generate is used to draw down additional federal matching funds, then is paid back to the providers in the form of directed payments to increase their overall reimbursement rate and to reward them if they meet certain performance or quality standards.
Currently, IHA estimates the hospital tax generates about $2 billion a year in revenue. This past session, lawmakers passed a bill to increase the assessment in order to fund a 54% increase in hospital payments, subject to federal approval of the state’s plan. But state lawmakers passed that bill before Congress passed Trump’s domestic policy bill, dubbed the “One Big Beautiful Bill Act.”
Prior to passage of the new federal law, the tax rate states could levy was effectively capped at 6% of a hospital’s net patient revenue. But under the new law, for states like Illinois that expanded Medicaid under the ACA, that cap will gradually be lowered by half a percentage point each year starting in 2028 until it reaches 3.5% in 2032.
In addition, Wilhelmi said, the new law imposes a cap on the directed payments that expansion states like Illinois can send to hospitals so that the total does not exceed the maximum allowed under Medicare – the federal health insurance program for seniors, which has a lower reimbursement rate than Medicaid.
“And that will result in a significant reduction in Medicaid reimbursements for hospitals,” Wilhelmi said. “It means literally hundreds of millions of dollars in less reimbursement to hospitals.”
$48 billion impact over 10 years
According to the nonpartisan health policy research organization KFF, federal Medicaid spending in Illinois is expected to be reduced by about $48 billion over 10 years under the new legislation. That includes an estimated $6.73 billion in spending cuts in rural parts of the state.
Democratic Gov. JB Pritzker has been harshly critical of the new law, and particularly the Medicaid cuts contained in it.
“Donald Trump isn’t just cutting health care — he’s also closing hospitals in Illinois and across the country with his latest scheme,” Pritzker said in one social media post while the bill was moving through Congress. “Hard-working Illinoisans will spend more time in overcrowded waiting rooms and lose access to life-saving care.”
Wilhelmi, meanwhile, said there is still time before the cuts begin to take effect, and he is urging state officials to begin work immediately to develop strategies to adapt to the changes.
“I think the state will need to work with stakeholders like IHA and our hospitals, other provider groups, to identify creative options to ensure that the Medicaid program can continue to be that lifeline for vulnerable patients and communities,” he said. “And that will include identifying options to fortify those programs and services, as well as identify working with our congressional delegation on ways to mitigate or further delay these changes.”
Capitol News Illinois is a nonprofit, nonpartisan news service that distributes state government coverage to hundreds of news outlets statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation.
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Pritzker warns 330,000 Illinoisans could lose Medicaid under Trump’s budget plan
Capitol News Illinois
Article Summary
The U.S. House gave final passage Thursday to a bill that will cut federal Medicaid spending in Illinois by an estimated 20%, or $48 billion, over 10 years.
Medicaid pays for about 40% of all childbirths in Illinois as well as 69% of all nursing home care, according to an independent analysis.
State officials estimate 330,000 Illinoisans could lose Medicaid coverage if President Donald Trump signs the bill into law.
The Illinois Department of Public Health said nine rural hospitals in Illinois would face closure or severe service reductions due to the cuts.
This summary was written by the reporters and editors who worked on this story.
SPRINGFIELD — The U.S. House gave final passage Thursday to a budget bill that will cut federal Medicaid spending by an estimated $1 trillion over 10 years.
All three Republican members of the Illinois congressional delegation voted in favor of the bill, despite a last-minute plea from Democratic Gov. JB Pritzker who warned the bill will result more than 330,000 Illinoisans losing Medicaid coverage and have a devastating effect on some rural hospitals.
“As those who are entrusted with protecting the health of all your constituents, I urge you to oppose these harmful Medicaid provisions and work to protect healthcare access for rural Illinois families, workers, and veterans,” Pritzker wrote in the letter addressed to GOP Reps. Mike Bost, Darin LaHood and Mary Miller.
The cuts would translate to about $48 billion in Illinois over that period, or about 20% of what the state would otherwise receive, according to an analysis by KFF, a nonpartisan health policy research organization.
That would be one of the largest percentage reductions in any state in the nation, according to KFF, a nonpartisan health policy research organization formerly known as the Kaiser Family Foundation. Louisiana and Virginia would each see cuts of about 21%, KFF said.
The state-level analysis is based largely on Congressional Budget Office estimates showing the bill would reduce federal Medicaid spending by $1 trillion nationwide over the next decade.
The KFF analysis does not include estimates of the number of people who would lose Medicaid coverage under the bill, noting how that will depend on how individual states respond to the policy changes contained in the bill. But overall, it estimates the number of uninsured Americans will grow by 11.8 million.
The bill, which includes many of President Donald Trump’s domestic policy priorities – including tax cuts and increased spending on border security – passed the Senate on Tuesday by a vote of 51-50, with Vice President J.D. Vance casting the tie-breaking vote. Both senators from Illinois, Democrats Dick Durbin and Tammy Duckworth, voted no.
The final vote in the House was 218-214.
“The One Big, Beautiful Bill is a once-in-a-generation victory for the American people,” Miller said in a statement after the House vote. “It delivers on President Trump’s America First agenda with bold, decisive, and immediate action. This is the most pro-worker, pro-family, pro-America legislation I have voted for during my time in Congress, and I was proud to help get it across the finish line for the hardworking Americans across my district.”
Medicaid and the health care marketplace
Medicaid, which is jointly funded by states and the federal government, provides health coverage for lower-income individuals and families. It was established in 1965 alongside Medicare, the federally funded health coverage program for people over 65.
Today, according to the Illinois Department of Healthcare and Family Services, the program covers about 3.4 million people in Illinois, or a fourth of the state’s population. At a total cost of $33.7 billion a year, it is one of the largest single categories of expenditures in the state’s budget. It pays for about 40% of all childbirths in the state, according to KFF, as well as 69% of all nursing home care.
But questions about its future loomed over the Illinois General Assembly during the just-completed legislative session as both Congress and the General Assembly were crafting their respective budgets for their upcoming fiscal years.
“This was a difficult year because of the unprecedented changes and cuts that are looming on the horizon in Washington,” state Rep. Anna Moeller, D-Elgin, said on the floor of the Illinois House during debate over a Medicaid bill on the final day of the session.
Read more: Amid uncertainty in Washington, Illinois lawmakers pass slimmed-down Medicaid package
Speaking with reporters at an unrelated event Tuesday, Pritzker predicted “hundreds of thousands” of people in Illinois will lose Medicaid coverage if the Senate bill is signed into law.
“This is shameful, if you ask me, and it’s going to be very hard to recover,” Pritzker said. “The state of Illinois can’t cover the cost – no state in the country can cover the cost of reinstating that health insurance that is today paid for mostly by the federal government, partly by state government.”
Policy changes under the bill
According to KFF, most of the reductions in Medicaid spending would result from just a few policy changes contained in the bill
Those include imposing a work requirement on adults enrolled in Medicaid through the Affordable Care Act, also known as “Obamacare.” That law expanded eligibility for Medicaid to working-age adults with incomes up to 138% of the federal poverty level. About 772,000 people in Illinois are enrolled under that program.
The bill also calls for requiring people enrolled through the ACA expansion to verify their continued eligibility for Medicaid twice a year instead of annually. That is expected to filter out enrollees whose incomes rise above the eligibility limit as well as those who simply fail to complete the verification process.
Another provision would limit the ability of states to finance their share of the cost of Medicaid by levying taxes on health care providers. Illinois imposes such taxes on hospitals, nursing facilities and managed care organizations that administer the program. Revenue from those taxes is used to draw down federal matching funds that are then used to fund higher reimbursement rates to health care providers.
The final version of the bill does not, however, include a provision penalizing states like Illinois that also provide state-funded health care to noncitizens who do not have lawful status to be in the United States. That provision, which was included in the earlier House version, was not included in the Senate bill, according to KFF.
Capitol News Illinois is a nonprofit, nonpartisan news service that distributes state government coverage to hundreds of news outlets statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation.
The post Pritzker warns 330,000 Illinoisans could lose Medicaid under Trump’s budget plan appeared first on Capitol News Illinois.