SPRINGFIELD, Ill. • Historic Medicaid cuts pending in Illinois will worsen the plight of poor residents already reeling from reductions in other services, those who work with low-income Illinois residents say.
"Are we doing this because these are the people who can't scream the loudest and don't have the backing to stand up for themselves?" asked Janice Donaldson of the Good Samaritan House in Granite City, which serves homeless women with children.
It's the same question some legislators asked on the Illinois Senate floor Thursday, before final passage of $1.6 billion in Medicaid cuts. But supporters of the cuts say the entire system is at risk if costs aren't brought under control.
The cuts will move hundreds of thousands of clients off the state's health care program for the poor. For those who remain, it will mean less coverage for prescriptions, dental care and eyeglasses, and no coverage for chiropractic or podiatric care.
Hospitals will get lower fees for providing services to Medicaid patients. Programs that provide health care or prescriptions for the elderly or families with children will have tighter income-eligibility rules.
Donaldson said some of her clients recently have found it more difficult to find day care for their children because of program cuts. Many low-income people can't hold certain kinds of jobs because of medical issues, she said, and if they can't get medication, it will complicate their problems.
"To me, there have to be other places to make cuts than to take away from the people that have so little anyway," she said.
Joe Hubbard, coordinator of Catholic Urban Programs, which serves Southern Illinois, including a large part of St. Clair County, said cuts to prescription programs will hurt.
"That's going to be devastating to the poor," he said. "It's going to put a big burden on those who are already struggling."
When the poor can't get coverage of dental and podiatric services, they go without, which can lead to more expensive medical bills later, Hubbard said. "One of the major problems I see is it's going to cause more long-term care, where people wind up in the hospital longer."
The cost of Illinois' Medicaid program has been "out of bounds" for 25 years or more, Hubbard said.
"I could see that something has to be done to get it under control, you know," he said. "Then again, by doing that, a lot of people who need services are going to wind up being the ones that suffer from it."
Supporters of the cuts in both parties say they're needed to prevent a collapse of the debt-laden Medicaid system, which spends about $15 billion a year in state and federal funds to serve 2.7 million Illinoisans and has become one of the biggest drains on Illinois' annual budget.
"This is the first step toward saving Medicaid for those that rely upon it," Democratic Gov. Pat Quinn said in a statement shortly after the passage of the cuts, which he has championed as part of a major budgetary stabilization effort that also will include state pension reforms. "The status quo would have led to Medicaid's collapse. I am pleased to see the General Assembly take strong action to put our Medicaid system and our state on the path to sound fiscal footing."
The cuts passed Thursday, which Quinn is expected to sign, include elimination of Illinois Cares Rx, a prescription drug program that helps about 180,000 low-income seniors pay for their medicine. They will limit participation in the Family Care program of health coverage for people caring for relatives' children, limiting participation to people at 133 percent of the federal poverty rate.
Medicaid recipients will be limited to one pair of glasses every two years (there's currently no limit), and they will no longer get chiropractic and podiatric services. Recipients also would be limited to four prescriptions without prior approval from the state.
The bill also includes tighter standards to prove clients are eligible to be on the Medicaid, which by some estimates could nudge 300,000 people off the program. It also would cut by 3.5 percent the fees that the state pays to hospitals that provide Medicaid services.
"They are … balancing the budget on the backs of the poor," Sen. Mattie Hunter, D-Chicago, said during emotional floor debate Thursday before the Senate gave final approval to the bill. "I don't see how they're going to sleep."
Republicans, too, expressed reservations about the measure, because it cuts reimbursements to hospitals that serve Medicaid patients.
"A third of hospitals in Illinois are in the red. … There's no way to know if this is going to put them over the edge," said Danny Chun, spokesman for the Illinois Hospital Association. "It's possible some of them may not make it."
The group opposed the rate cuts but supports the overall Medicaid reform package, which ultimately is expected to include a $1 boost in the state's cigarette tax that the Legislature began passing this week.