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Preckwinkle: GOP health care plan will ravage Cook County budget

Thursday, March 09, 2017
Chicago Tribune
by John Byrne

Preckwinkle: GOP health care plan will ravage Cook County budget


Democratic Cook County Board PresidentToni Preckwinkleon Wednesday acknowledged a Republican plan to replaceObamacarecould blow a huge hole in the county budget, but vowed to find the money to provide health care for hundreds of thousands of residents who could lose coverage.

Preckwinkle said the bill unveiled this week by HouseRepublicansin Washington, "is not terribly encouraging; in fact, it's pretty discouraging." Particularly troubling, Preckwinkle said, is the GOP proposal to roll back theMedicaidexpansion in the Affordable Care Act.

"What we've seen thus far from the House of Representatives will ultimately result in fewer people having access to health care coverage, especially those who rely on expanded Medicaid," Preckwinkle told reporters after a county board meeting. "We can only hope that sanity prevails in the upcoming debate."

According to Dr. John Jay Shannon, the county health system's CEO, roughly 350,000 people in Cook County now get health insurance thanks to the Obamacare Medicaid expansion. Another 100,000 to 150,000 are insured through Obamacare marketplace plans, he said.

In all, Preckwinkle said, county government's taxpayer subsidy to the health care system has gone down $289 million since 2010, "partly due to efficiencies but mostly due to the substitution of federal dollars for local dollars." Shannon has said about $200 million of that is due to Medicaid expansion.

It's not clear how much those expenses would go back up under the GOP proposal, and it's far from certain the plan will pass in its present form.

Preckwinkle said the county would cover the added costs, but declined to say where she'd get the money. In recent years, Preckwinkle has pushed through a sales tax hike and a new sweetened beverage tax.

The two-term board president said the county health system has existed for almost 200 years, and "we're not going to turn our backs on that legacy. We will continue to provide the care that we've always provided. We'll have to find another way to do it."

Republicans have proposed per-capita health care spending similar to block grants as an alternative to the Medicaid expansion. That would be a particular problem here because Illinois gets relatively little federal matching money per capita compared with other states, Shannon said.

Preckwinkle said she spoke to Republican Gov. Bruce Rauner last week about the hit Illinois would take under the GOP plan and asked him to reach out to Republican members of the state's congressional delegation to urge them not to support rolling back the Medicaid expansion.

On Tuesday, Rauner said he had talked with fellow governors and members of theTrumpadministration about his concerns regarding Medicaid. His "first-blush read" was that Illinois "won't do very well under the changes that they're recommending, which is a big concern to me," Rauner said.

Twitter @_johnbyrne

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