Feb. 04--In 2013, when they committed Illinois to a big expansion of Medicaid coverage, Democratic lawmakers soothed taxpayers with a relentless talking point: Don't worry. The feds will pay for most of this. What could go wrong?
On Tuesday the Tribune's Ellen Jean Hirst offered one early answer. Two years from now, when Illinois taxpayers start covering a portion of the expansion costs, they'll be paying far more than the $573 million they were told they'd have to pay from 2017 through 2020. The real cost will be at least $907 million. And a document sent to the federal government last summer by the office of then-Gov. Pat Quinn said that number could swell to $2 billion.
Chalk it up as one more failure of past management that Gov. Bruce Rauner faces Wednesday as he delivers his State of the State address.
In dollar terms, this gross underestimation competes nicely with the bogus budget that Quinn and legislative Democrats adopted for the current fiscal year. Last fall the nonpartisan Civic Federation of Chicago found many misleading gimmicks in the budget and said that rather than reducing spending by $1.1 billion, it hikes spending by $528 million -- yet underfunds agencies by $470 million. This blindness to how many people would flock to expanded Medicaid -- some of them evidently refugees from private insurance -- also evokes the current budget's intentional underfunding of some $300 million for a state child care program. On Monday the Tribune's Kim Geiger reported that payments to providers will be delayed starting this month.
These messes and more now land in Rauner's lap. We're amused by demands from Democratic legislators that he promptly offer solutions to problems they created and Quinn signed into law.
The inept 2013 cost projection for a massive Medicaid expansion is a perfect case study of the state of this state. We didn't oppose the bill. But we did say we hoped that, a decade or two later, Illinoisans wouldn't look back and ask: What were they thinking? How could the politicians be so willfully blind to the billions that the Medicaid expansion would cost taxpayers?We asked if future citizens would regard this with the disdain and rage of those who now see pensions devour money that can't go to schools, social services and other priorities. Would they ask how pols burned by their pension crisis could again commit Illinois to spend money it didn't have?
But you don't have to wait a decade or two to voice disdain and rage over the Medicaid mess Illinois lawmakers have made. And these rising cost estimates assume the feds will keep paying the vast share. We doubt that Rauner expects a broke federal government to perpetually pay Medicaid expansion costs to a broke Illinois government. U.S. Rep. Paul Ryan, now head of the House Ways and Means Committee, told us in April 2013 that, over time, debt pressure would doom such high reimbursements: "It doesn't matter if Republicans are running Congress or Democrats are running it. No way are we going to keep those match rates like that."
So, Gov. Rauner, you've inherited someone else's Medicaid debacle. Would that it was the only such debacle. The state of this state? Critical.
