SPRINGFIELD – Illinois lawmakers got a lesson Thursday in the challenges of cutting a health care program that serves nearly 3 million of the state’s residents.

The state Senate took the rare step of discussing Medicaid in a “committee of the whole,” meaning the entire chamber meets to focus on a single issue. A national Medicaid expert briefed lawmakers and made clear that it won’t be easy to slash spending by nearly 20 percent, as Gov. Pat Quinn proposes.

“Over one year or over two years, those are hard numbers to get out of the Medicaid program,” said Joy Johnson Wilson, health policy director for the National Conference of State Legislatures.

Most Illinois officials agree Medicaid costs are growing so fast that the state can’t keep up. The government is falling further and further behind in paying the doctors and hospitals that provide services. If nothing changes, Illinois could end Fiscal Year 2017 with $21 billion worth of Medicaid bills it can’t pay.

Quinn, D-Chicago, says the program must be overhauled to control spending growth. He wants to cut costs by $2.7 billion, or nearly 20 percent, in the coming year. Wilson told senators that she doesn’t know of a state that has made such deep cuts in a single year.

State Sen. Christine Johnson, R-Shabbona, serves on the Medicaid Task Force, a bipartisan panel charged with developing solutions to Illinois’ massive Medicaid funding issue. In a news release issued Thursday, she said Medicaid in Illinois is on the brink of a financial collapse.

Johnson noted that Thursday’s presentation came a month before Quinn’s April 24 deadline for legislators to come to an agreement on how to finance the state’s burgeoning Medicaid obligations.

“The presentation [Thursday] provided some new insight that I think will be helpful in future discussions. Point blank – it is time for us to make some decisions,” Johnson said in the news release.

Johnson said the number of residents on Medicaid has doubled to nearly 2.8 million people in the past 12 years and is expected to add 160,000 people into the program this year.

“That is like adding the entire population of Joliet to an entitlement program that is already almost $3 billion in debt,” she said.

Sen. Donne Trotter, who specializes in budget issues, said Illinois stands alone in the scale of its Medicaid problems. “Misery loves company and we don’t have anybody out there to be miserable with us,” the Chicago Democrat said.


Medicaid costs can be cut in three basic ways: reducing the range of services offered, making sure fewer people are eligible for coverage or paying less to Medicaid providers.

The federal Affordable Care Act limits states’ ability to reduce eligibility. Washington also requires certain services to be included in all Medicaid programs.

But there are some optional services, such as dental care, that states can cut. Wilson warned that even cutting those services can be tricky. Arizona, for instance, cut dental care but then found more people ended up going to the hospital for dental problems.

Sen. Dale Righter, R-Mattoon, said it may be complicated but the situation is too perilous to allow for tinkering around the edges. Optional services will end, he predicted — either because the state cuts them now or because Illinois’ Medicaid system collapses in the future.

“There is no longer a choice,” Righter said. “This is between saving the program as we know it or losing it.”

• Daily Chronicle staff contributed to this report.