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Health care ruling a 'win, win, win' for Cook County, health official says

Thursday, June 28, 2012

by Alex Keefe

The head of Cook County's hospital system had high praise for the U.S. Supreme Court's health care ruling Thursday, saying the justices' decision to uphold a planned expansion of Medicaid could mean tens of millions of dollars a year for the cash-strapped health care network.

"It is a win, win, win for everybody" in Cook County, said Dr. Ram Raju, CEO of the Cook County Health and Hospitals System. "It is a win-win for the patients first. Second, we get an opportunity to redesign the system ... the way it should be redesigned."

The high court's decision could clear the way for the county's hospital system to rake in up to $70 million a year in new federal reimbursements for Medicaid, the government health care program for the poor. President Barack Obama's health care law expands Medicaid coverage to people making less than $14,856 a year, starting in 2014.

The hospital system serves about 100,000 of those patients each year, many of whom don't have insurance but currently make too much money to qualify for Medicaid. Thursday's ruling means Cook County could soon begin to get federal money to help pay for their care, Raju said.

Twenty-six states had challenged part of the health care law that would have let the federal government withhold Medicaid money if states chose not to comply with its requirements. On Thursday, justices ruled it is okay for the federal government to put conditions on states that accept the new Medicaid dollars. But they said states that opt out altogether can't be punished by having all their existing Medicaid funding pulled, as the law originally allowed.

The Supreme Court's ruling seems to leave room for some states to opt out of the expansion. But Illinois' Democrat-controlled General Assembly and Democratic Gov. Pat Quinn have already signed off on a federal waiver application that could allow Cook County to start raking in new Medicaid dollars even before the 2014 start date, Raju said.

Despite the court's ruling, Raju said he's confident state politicians won't go back on their earlier decision.

"I sincerely hope the State of Illinois will make use of this Medicaid expansion for our poor people and the people without access," he said.

Cook County's request must still be approved by the federal agency that oversees Medicaid, Raju said. He's hoping approval could come as soon as July 1.

Thursday's court decision comes a day after Cook County budget officials projected a $267.5 million budget deficit for the next fiscal year. About $152 million of the shortfall came from the county hospital system, which has been burdened during the economic downturn by more and more patients who don't have insurance.

County hospitals are often the go-to choice for people who don't have health insurance: 85 percent of emergency room paitients and 55 precent of hospital patients are uninsured, according to the county.

In a statement, Cook County Board President Toni Precwinkle lauded the Supreme Court's decision.

"CCHHS is the foundation of the safety-net health network in northeastern Illinois," the statement reads. "Today’s decision by the Supreme Court will allow our system to proactively prepare for Affordable Care Act implementation in 2014.”



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