No free lunch
Despite all the new health care law accomplishes, it doesn’t come for free.
Since more people will soon qualify for Medicaid and that program’s reimbursement rates for doctors are scheduled to increase to Medicare levels – sometimes double current Medicaid levels – Illinois will soon see an influx of new enrollees in Medicaid. It is too early to tell how many, but the Congressional Budget Office in Washington, D.C., estimates 16 million new people nationwide will enroll in Medicaid by 2019. The Kaiser Foundation estimates that 812,100 uninsured Illinoisans currently fit the new Medicaid qualification of income below 133 percent of the federal poverty level. Kaiser spokesman Chris Lee says that number includes illegal immigrants, who do not qualify for Medicaid, as well as people who already qualify but aren’t enrolled.
Luckily for the cash-strapped State of Illinois, the federal government will pay 100 percent of the cost of new enrollees in 2014, when the expansion takes effect. That will drop to 90 percent by 2020, and much of the cost will be paid by taxes on high-earning individuals and couples, as well as taxes on investment income, expensive health insurance plans and even indoor tanning.
Stacey Solano, spokeswoman for the Illinois Department of Healthcare and Family Services, which oversees Medicaid in Illinois, says the department will likely have to hire more staff to administer the swelling Medicaid rolls. However, those arrangements have yet to be made, Solano says, so it’s difficult to tell how much money the extra workers will cost the state. For Springfield, more HFS workers likely means more jobs, since HFS bases a large number of its workers here.
Small businesses, comprising more than 70 percent of Sangamon County businesses, will also be affected by the new law, with incentives to provide employees with health insurance and penalties if they don’t. Businesses with 10 or fewer employees and annual average employee wages of less than $25,000 will be eligible for a tax credit of up to 35 percent of employee premiums until 2013. A sliding scale provides smaller benefits for larger companies, and small businesses that purchase insurance through a public health exchange will be eligible for a tax credit of up to 50 percent. There are more than 3,700 Sangamon County businesses with fewer than 10 employees, employing more than 10,000 workers county-wide, according to the Illinois Department of Employment Security. Businesses that fail to provide adequate health insurance – the meaning of which is to be determined later by the government – will pay a tax penalty of $2,000 per employee.
Healthy debate
Opposition to the new law has run hot in Illinois, with all of the state’s Republican representatives in Congress voting against the law and many now vowing to repeal it. U.S. Rep. John Shimkus, a Republican, represents Illinois’ 19th congressional district, which covers the northwestern third of Springfield. Shimkus has
an entire section on his official Web site devoted to the negative aspects of the new law.
Republican Rep. Aaron Schock, representing the 18th district, which covers the southwestern third of Springfield, said in a statement on his official Web site that “a government takeover of health care will raise taxes, ration care and let government bureaucrats make decisions that should be made by families and their doctors.”
There’s so much to this law that it is easy to see why it has spawned so much controversy. But don’t get too excited (or angry, depending on your views) just yet; many aspects of the law don’t take full effect until 2014.
In the meantime, Ed Osman isn’t holding his breath for things to improve.
“Some of that stuff doesn’t take effect for years,” he says. “We’re not really going to know what it all does until it they start implementing it.”
His advice for now? “Don’t get old. It sucks.”
Contact Patrick Yeagle at [email protected].
