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State’s Medicaid applications adding up

Updated: December 25, 2013 6:24AM



It’s been about 30 years since Kenneth Faulkner last had health insurance. He lost it when he lost his job at the U.S. Postal Service in 1983.

So whenever the 61-year-old Kankakee resident needs to see a doctor, he “self-medicates” with over-the-counter painkillers or drives to the Cook County Health & Hospital System, which often is the go-to for uninsured people.

On Jan. 1, Faulkner, now an auto mechanic, will again have insurance — this time, Medicaid — and theoretically, have better options for health care. “I hope that it’s going to affect me in a positive manner, but I will wait and see,” he said.

Although many middle-class Illinoisans have struggled to sign up for health insurance on the troubled federal HealthCare.gov site, low-income people in Illinois have had an easier time and are enrolling by the thousands.

In Illinois, just 1,370 individuals selected an insurance plan in October through HealthCare.gov, which was created by President Barack Obama’s health care law. But the other part of the Affordable Care Act, also known as Obamacare, that kicked in Oct. 1 — expanding Medicaid — shows better turnout.

More than 47,000 low-income people in Illinois have applied for Medicaid since October on the state-run website, abe.illinois.gov/abe/access/. Illinois also got 42,000 additional Medicaid applicants by sending a letter to the 123,000 people receiving food stamps in August. Another more than 100,000 people in Cook County, where an early Medicaid pilot program began a year ago, have already enrolled.

More people in Illinois may have signed up for Medicaid through the federal website, HealthCare.gov, but the specific number is not known. Coverage for those applicants may be delayed past Jan. 1 because of the website problems.

Illinois was one of 25 states plus the District of Columbia that chose to expand Medicaid after the U.S. Supreme Court gave states the choice to do so. The state estimates that 342,000 people in Illinois will enroll in Medicaid because of the change in the law by 2017.

Other states have similarly seen strong numbers for Medicaid enrollment.

Matt Salo, the executive director of National Association of Medicaid Directors, said the numbers aren’t surprising, given the states’ ability to cross-reference people who already benefit from other low-income assistance programs as those who would likely qualify for Medicaid.

“Once you get the “low hanging fruit” of [food stamp] recipients, for example, enrollment will taper off,” he said. “Coverage, on some level, is the easy part. The challenge is, once you get people covered, how do you actually improve their health care outcomes and reduce the cost curve.”

It’s unclear how many of Illinois’ enrollees already were eligible but didn’t realize it until the ACA rollout.

Medicaid is for low-income people who make below $15,860 for an individual and $21,408 for couples. It used to be that Medicaid was only available to children, their parents or guardians, seniors or adults with disabilities.

Medicaid is far from comprehensive; it won’t cover adults’ dental or vision care. Yet, proponents of the expansion are quick to point out that it’s better than having no insurance. There’s also no guarantee doctors will accept new Medicaid patients, because of what providers say is low and slow reimbursement. The state says those issues will be addressed in part by the accountable care organizations they’re creating for Medicaid patients.

And there’s the question of whether Illinois will be able to pay its portion of the new Medicaid enrollees; the state will be gradually expected to pay up to 10 percent for those who became eligible through the ACA. For patients eligible under the old bill, the state must pay about 50 percent.

State officials say the more than $12 billion they expect in new federal funding between 2014 and 2020 will offset the new costs from the growing Medicaid population.

Email: mjthomas@suntimes.com

Twitter: @MonifaThomas1



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