Department of Healthcare and Family Services acting Director Elizabeth Whitehorn told stakeholders last week that “chaos and uncertainty” at the federal level has them scrambling to understand the potential impact on the state’s Medicaid program and related initiatives. [Health News Illinois]
She told members of the Medicaid Advisory Committee they have not had any issues accessing the federal portal to process Medicaid payments since it briefly went down last month.
However, the main concern right now is the potential for Medicaid cuts.
Whitehorn said Congress is considering several potential changes to Medicaid, but department officials are focused on two: implementing a per capita cap to limit federal Medicaid funding to states and repealing the Affordable Care Act’s Medicaid expansion.
Roughly 770,000 Illinoisans could be affected by the repeal of the expansion, Whitehorn said, with the state receiving $7.4 billion to provide coverage for them.
Illinois is one of nine states to have a so-called trigger law on the books that would remove that population from the rolls if the federal government reduces the level of federal match to anything under 90 percent.
“We are very concerned — extremely concerned — about how far these will go, and what they would do to our program here in Illinois and across the country,” Whitehorn said.
She told committee members the only solution they currently have is to promote the importance of ACA expansion and the negative healthcare impact of cuts.
As far as initiatives like the 1115 waiver, Whitehorn said they have received approval for the implementation of the health-related social needs portion related to housing, food and nutrition, and the department is moving forward with those.
But other steps like evaluation plans and monitoring plans have to receive federal approval, and Whitehorn said there is no guarantee the Trump administration will not either “slow walk” those negotiations or even “flaunt the law” and just cancel the waiver or refuse to pay for anything.
She said the agency’s attorneys are currently researching what steps to take if the federal government revokes any of the previously approved programs.
Medicaid Administrator Kelly Cunningham said one bright spot is the positive working relationship they have with staff at the Centers for Medicare and Medicaid Services.
“We're trying to make sure that we continue to cultivate those and take advantage of them where we can,” she said. “So from that perspective, I feel hopeful that our voices will be heard.”
###
