If Illinois Governor Bruce Rauner’s proposal to cut Medicaid dollars comes to fruition, kidney dialysis patients in 40 percent of the state’s treatment centers will no longer receive the proper care they often receive.
Gov. Brauner (R) suggested the $1.5 billion cut to Medicaid earlier this year, arguing that it would bring the state closer to closing its $6 billion deficit. Under the plan, some service providers will have their reimbursement rates slashed by nearly 17 percent. Nursing homes and drug treatment centers face similar cuts, to the chagrin of medical professionals and social workers.
Patients whose kidneys can no longer function undergo dialysis to eliminate the waste and unwanted liquid from their blood stream. Without the procedure, waste levels in the bloodstream could reach levels that cause coma or death. In Illinois, more than 28,000 people use dialysis machines routinely, causing advocates to worry, especially with the possibility of increase in emergency room visits looming.
“What I think it boils down to is these patients suffer enough with their disease, and we need to do everything we can to maintain access to high quality, local convenient care,” Dr. Tim Pflederer, president of Illinois Kidney Disease and Tension Center, told WQAD 8 this week.
The budget battle in the Illinois legislature took a turn for the worse last month when Democrats and Republicans debated about the best way to close the $6 billion budget gap. GOP lawmakers decried the possibility of tax hikes while Democrats wanted to steer clear of cuts to state programs. Gov. Rauner’s proposals have drawn the ire of stare union employees and agency leaders, many of whom have protested on the steps of the State Capitol in recent months.
For proponents of Medicaid cuts, the rationale is rooted in the cost of reimbursing hospitals and clinics for patient care. However, many advocates have pointed out that many of the people affected by the cuts wouldn’t be able to afford specialized health care otherwise. For them, a gap in these services would burden emergency care workers and drain hospitals of even more dollars.
That’s the situation that Obamacare proponents said they wanted to avoid. After the key provisions of the Affordable Care Act went into effect in 2012, Illinois’ Medicaid rolls grew by nearly 500,000. Studies conducted by the Robert Wood Johnson Foundation and Kaiser Family Foundation showed that Illinois, along with other states, enjoyed cost savings as hospitals absorbed the cost of treating fewer uninsured patients. However, the experiences of Medicaid patients served as a testament to the toll that the lack of preventative care takes on the sickly and emergency rooms alike.
While some hospitals saw a decrease in unpaid bills, officials said they also incurred millions of dollars in costs from new enrollees. For example, administrators at an Illinois hospital told the Wall Street Journal that it accrued a loss of nearly $5 million, most likely brought on by patients’ delayed care in the years they had no coverage.
Kidney dialysis patient Howard Wetterow said he doesn’t want the same to happen to him. Wetterow, an Illinois man who suffers from Wagner’s Disease, receives dialysis treatment three times a week, four hours per day. Without Medicaid dollars, he would no longer be able to receive this treatment at the facility located 15 minutes away from his home. “It’s real convenient for me. I can get up; I can leave home and in 15 minutes, I can come in, get hooked up and as soon as your four hours are over, you go home,” Wetterow told WQAD as he underwent his routine treatment.
This ongoing battles highlights quarrels unfolding in other states around Medicaid, the joint federal and state program that helps low-income individuals and families take on the cost of long-term care. Under the Affordable Care Act, Medicaid coverage expanded to include more low-income individuals in the program. However, the Supreme Court ruled the expansion to be optional when it upheld the law’s individual mandate.
Now, GOP-controlled states have been reluctant to implement the expansion. Even with the federal government’s promise to cover $2 billion in annual costs, many Republican leaders cite financial concerns.
South Carolina Gov. Nikki Haley (R), for example, has opposed Medicaid expansion that would help nearly 160,000 residents and save 200 lives per year, according to a recent White House report — referring to the policy as “the expansion of a broken Medicaid program that is already cannibalizing our budget, and would completely destroy it in the years to come.” Lawmakers and hospital administrators in Florida are also going head-to-head about Medicaid expansion amid a budget battle. The state House of Representatives will discuss what some consider a controversial proposal to expand federally subsidized health insurance to hundreds of thousands of low-income Floridians.
If all states follow through, four million low-income Americans who are currently going uninsured would receive Medicaid benefits. According to a recent New York Times analysis, the national uninsurance rate would be two percentage points lower.