Health Care Bill Comes with Price Tag Estimated at 5-$12 Billion Per Year or More
Sen. Mattie Hunter (D-Chicago) passed legislation Thursday reforming medical care for minority communities. Republicans say the 5-$12 billion price tag is too much for the state to afford.
A massive health care reform bill aimed at saving lives and increasing equity in African American and Latino communities is headed to Governor Pritzker’s desk for signature, even as Republicans said the state can’t afford the high cost of the legislation.
The legislation, HB158, passed the Senate Thursday and the House last week mostly along party lines. The bill makes changes to multiple Medicaid services, covers pregnancy services, like home visiting doulas, under Medicaid, adds child care assistance, and places a moratorium on hospital closures.
Much of the bill does not have a direct funding source, meaning the programs would need to be appropriated in the state budget. It is unclear how that would be paid for. Republicans say their estimates show the bill could cost between 5 and $12 billion out of the state’s general fund. That represents almost a quarter of the budget Governor JB Pritzker has proposed for the Fiscal Year 2022 budget.
“COVID has spotlighted the state disparities and inequities in the black communities and the brown communities across our state,” said Rep. Camille Lilly (D-Chicago), one of the sponsors of the legislation. “Health care has to be looked at through [an] equity lens. Inequity must be addressed. Because, if it’s not, your life expectancy will be dependent on your ZIP code. We must look at the inequities as our priorities as we look at our budget.”
Many Republicans said they supported the efforts of the bill, but couldn’t justify the cost.
“I think it does a number of things that are very important and very good. I think the focus we need to place on ending health disparities, especially those that manifest themselves along the lines of race and that have become so visible during this COVID pandemic are very important,” said Rep. Ryan Spain (R-Peoria). “But, there’s a problem with this legislation. Cost estimates for this bill range anywhere in the magnitude of $5 billion per year to 12 or perhaps even $15 billion per year. I think we need to be very sensitive to the fact that the people of Illinois need to understand what we’re actually able to accomplish when bills pass out of this chamber in this Capitol. When you think about cost implications of at a minimum of $5 billion, I have some very significant concerns.”
The division over the legislation fell fully along party lines.
“We cannot not afford it,” said Sen. Jacqueline Collins (D-Chicago): “How do you put a price tag on somebody’s life? We must do everything we can to protect the life of every mother and their child.”
“We just can’t afford it. That’s really what it comes down to,” said Sen. Steve McClure (R-Springfield) on the Senate floor Thursday.
Rep. Lilly suggested the state can use a portion of $7.5 billion of federal stimulus dollars to pay for a portion of the project.
“We do have a start as to where revenues are coming from,” she said. “I really believe that the revenue will be prioritized so that we have better health outcomes.”
But Spain says there isn’t enough stimulus money, or general fund money, to go around. :
“I get very concerned that this bill is subject to appropriation to the tune of billions and billions of dollars and that we’re already thinking, as a legislative body, how we may expand our spending beyond the obligations that we already have,” Spain said. “I remind everyone [that $7.5 billion] is a one time infusion. If we begin to take special one-time federal money and apply it to new spending like this, we’re doing a terrible disservice to the taxpayers of Illinois and to the people that require health care improvements in all of those communities.”
Governor JB Pritzker praised the legislation in a statement Thursday.
“For too long, our healthcare system has left behind Black and brown communities creating disparities in health outcomes. From standing up a process to certify and train community health workers, to funding new services like doulas and home visiting, to increasing oversight and transparency around Medicaid managed care system for its customers, this bill roots out racism from our healthcare system and state government, a cause I’m proud to advance.”
We asked the Governor’s office if Pritzker had concerns about the cost of the legislation or if he suggests a way to pay for it, but a spokesperson did not return a message from The Illinoize.
