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* Forget about the political framing in this New York Times article, and think of the damage this could do to Illinois’ budget…
As Congress opens a politically charged exploration of ways to pare the deficit, President Obama is expected to seek hundreds of billions of dollars in savings in Medicare and Medicaid, delighting Republicans and dismaying many Democrats who fear that his proposals will become a starting point for bigger cuts in the popular health programs.
The president made clear his intentions in his speech to a joint session of Congress last week when, setting forth a plan to create jobs and revive the economy, he said he disagreed with members of his party “who don’t think we should make any changes at all to Medicare and Medicaid.”
Few Democrats fit that description. But many say that if, as expected, Mr. Obama next week proposes $300 billion to $500 billion of savings over 10 years in entitlement programs, he will provide political cover for a new bipartisan Congressional committee to cut just as much or more.
* Illinois’ budget simply cannot take a major hit on Medicaid without kicking a whole lot of people off the system. Period. End of story. Why? Read on…
Illinois had more poor people last year than it has had in nearly two decades, according to data released Tuesday by the U.S. Census Bureau that also showed the number of impoverished nationally at a new high.
More than 1.82 million people lived in poverty in Illinois last year, up from 1.69 million. That was the biggest number of poor since 1992 when there were 1.86 million people who were impoverished.
The poverty rate last year rose to 14.1 percent from 13.2 percent in 2009, data showed. […]
The report also revealed the percent of uninsured in Illinois rose to 14.8 from 14.2 in 2009. There were 1.91 million people uninsured in the state last year, up from 1.81 million. Nationally, 49.9 million Americans had no health insurance, or 16.3 percent, up from 16.1 percent, or 49 million.
Median household income in Illinois fell 5.5 percent to $50,761 last year from $53,743, the report showed. Nationally, it dropped 2.3 percent to $49,445, from $50,599. Since 2007, median household income has declined 6.4 percent. [Emphasis added.]
Oy.
* More misery…
“In the fiscal year that ended June 30, we serviced 5.1 million individual visits to our food pantries,” said Bob Dolgan, spokesman for the Greater Chicago Food Depository, which operates 650 pantries, soup kitchens and shelters in the city and Cook County. “You go back just three years ago, it was 3.2 million visits.”
Cuts to even relatively small government assistance programs are making it difficult to serve the growing numbers of poor, said Shurna, citing an 87 percent cut to an $11 million state program designed to prevent homelessness.
“So many people are just one catastrophe from becoming homeless, suddenly unable to make a house or rent payment because of unforeseen medical bills or some other emergency,” he said. “Now, because of this cut, 10,371 such people will not be helped.”
“It’s a lost decade for the middle class,” said Sheldon Danziger, a poverty expert at the University of Michigan.
Indiana 16.3 percent, Ohio 15.3 percent, Kentucky 17.7 percent, Michigan 15.5 percent, Missouri 14.8 percent, Wisconsin 9.9 percent.
* A very depressing national poverty rate graph…
* Meanwhile, the governor’s staff had to straighten out a nervous bond trader…
Quinn last week announced $313 million in budget cuts through the shuttering of seven state facilities and slashing 1,900 jobs. He pressed lawmakers to either increase spending in the $33 billion budget or reallocate funds to support the facilities.
Michael Brooks, a senior portfolio manager at Bernstein Global Wealth Management, slammed the governor’s comments, saying they might offset strides made this year to improve the state’s image in the investment community and lower its borrowing costs.
Brooks said the spread early this year of 250 basis points between five-year Illinois paper and triple-A rated debt has narrowed to 145 basis points in recognition of the state’s move to increase its income tax.
[llinois debt manager John Sinsheimer] said Quinn’s comments were directed specifically at the budgets for the various facilities being shuttered and not the overall budget.
But, hey, that’s probably what happens when you make a gigantic freaking public deal about a few million dollars in reallocations.
posted by Rich Miller
Wednesday, Sep 14, 11 @ 4:52 am
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Not having insurance would just be completely crazy. I am an accountant and in my local area “Penny Health” is the best health insurance finder I ever had. Yes my insurance does cover dental and eye insurance which is a big help to my life.
Comment by janicebaeza Wednesday, Sep 14, 11 @ 6:08 am
Unfortunately, the current federal health care law disallows states from reducing their Medicaid enrollment regardless of their financial situation. Other aspects of the law and regulations reinforce this with additional layers of prohibitions against Medicaid reform as we saw with the recent - very modest - Medicaid reform act here in Illinois. But legislation can repeal that most important of economic laws: Things that can’t continue won’t. Medicaid is coming to an end in Illinois if we can’t figure out how to protect it from the massive cost increases that are on their way due to federal mandates and cost shifting.
Comment by Confused Wednesday, Sep 14, 11 @ 6:23 am
How can anyone mention any economic problem, federal or state, without yelling WARS COST MONEY at the top of their lungs? There are people who spend money on their pets and don’t have food. They are mentally ill. Is mental illness a good trait in a politician?
Comment by MC Gone Wednesday, Sep 14, 11 @ 6:45 am
Even if the US were refunded every penny of out post 9/11 wars (thank you, Osama, may I have another), Illinois Medicaid would be UN desperate shape. The current trajectory was established long ago. But more importantly, the laws of economics - heck, simple math - don’t care about the past.
Comment by Confused Wednesday, Sep 14, 11 @ 7:24 am
Last week Atty Gen Holder announced arrest of many involved in Medicare fraud, to the tune of nearly a half-billion dollars; unfortunately, that figure is probably 1% of the total amt. being ripped off. Illinois has pitiful few investigators of Medicaid/welfare fraud, so we are not serious about program integrity. Attack the problem from every angle necessary, but don’t scoff when we brng up the need to reduce fraud in a major way
Comment by GMatts Wednesday, Sep 14, 11 @ 8:51 am
A huge portion of the state’s human service funding system in Illinois is based on some form of Medicaid reimbursement. Hospitals and medical providers have multi streams of revenue (insurance, comp, Medicare, Medicaid, and other contracts). Most non-hospital community human service providers have the state as the major funder, with Medicaid reimbursement rate as the primary driver. If Medicaid is changed significantly and GRF becomes the sole primary source for those providers, most of these programs will go away. The Gov’s request to close 7 state facilities will become the least of the problems.
Comment by zatoichi Wednesday, Sep 14, 11 @ 9:05 am
Here’s your problem. You have 1.8 million people in poverty but 2.5 million people on Medicaid. Sorry but the standards are too generous. Sorry we can no longer afford this.
Comment by BIG R. Ph Wednesday, Sep 14, 11 @ 9:22 am
BIG R. Ph:
And what do you suggest the people who cannot afford health insurance do? I know Rich hates the national issues talks on here, but I was flabbergasted at the Republican presidential debate the other night when they all basically agreed that everybody should be on their own when it comes to healthcare. How very compassionate.
Comment by Demoralized Wednesday, Sep 14, 11 @ 9:26 am
By the way, the poverty level for a family of 4 is $22,350. I can see how we are being so “generous” to those above that level. Give me a break.
Comment by Demoralized Wednesday, Sep 14, 11 @ 9:30 am
–Here’s your problem. You have 1.8 million people in poverty but 2.5 million people on Medicaid. Sorry but the standards are too generous. Sorry we can no longer afford this.–
Generous to whom, Big Pharma? The docs and the hospitals get the money. Are you suggesting they take a haircut? And who’s this “we” you speak of? If you’re talking about kicking poor people out of the healthcare system, it’ ain’t me.
The lede on the top story in the Trib today is “More Americans are living in poverty today than at any time in the last half century..”
That’s on us.
Time to sober up. No more endless, pointless wars. No more Wall Street hustles. No more Fox/Murdoch tabloid agenda for ignorant malcontents. No more fear of terrorists. No more fear at all — just work, work of any kind that does some good and is done with good will and optimism.
Our folks worked very hard and sacrificed much to give us a country better than the one they were born in or came to. Today, we can’t say that we’re doing the same for our kids. That has to change right now, or we’ll never forgive ourselves in the end.
Comment by wordslinger Wednesday, Sep 14, 11 @ 10:00 am
More than 1.82 million people lived in poverty in Illinois last year, up from 1.69 million. That was the biggest number of poor since 1992 when there were 1.86 million people who were impoverished.
The poverty rate last year rose to 14.1 percent from 13.2 percent in 2009, data showed. […]
****
Not to quibble, but they’re shifting raw numbers and percentages here. If you look at the population of Illinois in 1992, the poverty rate was 14.4% of the population, whereas in 2011 it’s 14.1%. That’s still not a great statistic, but the reality is as a percentage of the population, the poverty rate is not as bad as it was duing the last major recession.
Comment by John Galt Wednesday, Sep 14, 11 @ 10:06 am
Amen wordslinger!
Comment by Tired Wednesday, Sep 14, 11 @ 10:15 am
There is nothing more difficult to understand than for a family than to live in the richest country in the world and not have medical coverage.
To me. it seemed that the Obama Public Option health care plan was good for everyone but big pharma and medical institutions and insurance companies fought hard, on both sides, and defeated it. That one option alone, in my opinion, would have made health care more affordable for everyone.
I for one would gladly give up some of my Medicare benefits if the money could be put toward an affordable program for the uninsured.
Comment by Justice Wednesday, Sep 14, 11 @ 10:21 am
The ACA - which could eventually be nullified anyway - is full of (essentially) unfunded mandates. The promise was that required Medicaid expansion would be met with matching dollars and constant support from HHS (i.e. help with logistics, income guidelines and reimbursement rates). Guess what?! That’s all changed. If a Republican wins the Presidency, there is a good chance that all or most of the ACA initiatives will be completely defunded - assuming the Supreme Court even upholds the ACA. So we are going to expand Medicaid and then find a way to pay for it. Without getting political, this is like what happened during the Blago years: expand an expensive program and then worry about paying for it down the road. Either we start shuffling people off of Medicaid or we start charging beneficiaries a monthly premium and/or higher (or any) co-pays or we cut our reimbursement rates to pharmacists, physicians, clinics and hospitals even more. It’s going to be painful.
Comment by Team Sleep Wednesday, Sep 14, 11 @ 10:47 am
It’s good to see that the IL poverty rate is lower than the rate in four out of five contiguous states. Our rate is 15% lower than the rate in that Republican showplace to our east.
Comment by reformer Wednesday, Sep 14, 11 @ 11:18 am
**If a Republican wins the Presidency, there is a good chance that all or most of the ACA initiatives will be completely defunded **
That isn’t true. It will actually be very difficult to defund the ACA without have full control (i.e. 60+ votes in the Senate) of Congress and the White House
Comment by dave Wednesday, Sep 14, 11 @ 11:31 am
Dave, do you not think a Republican president would threaten to veto any spending that funds an ACA initiative? It’s also not out of the realm of possibility for a Republican president to issue an executive order or even instructing agency staff to alter or strip HHS money for a program.
Comment by Team Sleep Wednesday, Sep 14, 11 @ 11:56 am
Sounds like it is time for another Illinois tax hike and an assortment of new agencies and programs that will not only help the existing population in poverty but continue to attract people to the state as well.
The new tax may run away businesses but that is not important, we can all get jobs working for the government
Comment by Usual Illinois Liberal Wednesday, Sep 14, 11 @ 12:07 pm
Stop the war bring the money back to the good old U.S.A..Spending money for 10 years in Iraq and Afganistan is a waste of time and talent.Help the people of the U.S.A. End the war and we should have enough to help our own folks.
Comment by mokenavince Wednesday, Sep 14, 11 @ 12:28 pm
As a fiscal conservative, I agree we cannot continue these wars. As a patriot and father of a soldier, we cannot continue these wars, and NOT get into more of them (as we seem to be intent upon doing stealthily)
Comment by GMatts Wednesday, Sep 14, 11 @ 12:35 pm
Agree with Wordslinger and MokenaVince.
Comment by PublicServant Wednesday, Sep 14, 11 @ 12:37 pm
Hear, hear, Wordslinger!
Comment by Aldyth Wednesday, Sep 14, 11 @ 12:45 pm
Buried in the Census data is a pretty striking finding: the social safety net continues to work, for Americans who are elderly.
Between 2009 - 2010, the percentage of Americans living in poverty between the ages of 18-64 went up … but it continues to remain flat or even trend down slightly for Americans over 64. From the boom years of 2000 now to 2010, we’ve seen a huge uptick in poverty, but there are fewer elderly living in poverty in 2010 than in 2000.
This is not to bash on the elderly but to second mainly wordslinger’s point: government social safety nets can work. We can do this. What we desperately need is a lot of creative thinking about how to keep up the same opportunities and securities for current younger generations, and not just forty years from now when they hit retirement.
And that is going to require more money, and yes, some more taxes at the federal level. But in the long run, we’ll all be a wealthier country for it. Eventually, a sinking tide will even start beaching the yachts.
http://www.washingtonpost.com/blogs/ezra-klein/post/the-great-recession-in-five-charts/2011/09/13/gIQANuPoPK_blog.html
Comment by ZC Wednesday, Sep 14, 11 @ 1:14 pm
**Dave, do you not think a Republican president would threaten to veto any spending that funds an ACA initiative? **
It doesn’t really matter - much of the ACA is basically automatically appropriated. Without actually changing the law, large portions of the ACA cannot be defunded. And in order to change the law, Republicans would need to control Congress.
Comment by dave Wednesday, Sep 14, 11 @ 1:24 pm
To be a little clearer, much of the ACA is done through mandatory spending, meaning that the money gets spent unless the ACA is actually changed. The biggest parts of the ACA (the subsidies, Medicaid expansion, etc) are included in the mandatory spending.
There are parts of the ACA that can just be defunded through the appropriation process, but the vast majority of it cannot.
Comment by dave Wednesday, Sep 14, 11 @ 1:31 pm
Wordslinger, I agree with what you said but take a look, we now have troops on the ground in Libiya and we bore the majority of the cost of that well let’s be honest it was another war. Msnbc is as big a joke as fox but it’s a lib network so why mention it. I don’t think we can afford many more scams like the green jobs folks sold us Solyndra millions wasted because they support Obama. Maybe we could agree on common sense immigration reform until maybe every illegal immigrant should just claim to be Obamas aunt or uncle that seems to work. I agree with the just work idea I have two jobs and try and get all the OT I can but guess what not enough people want to work. Maybe if we would quit extending unemployment some people might magically find jobs.
Comment by Fed up Wednesday, Sep 14, 11 @ 2:08 pm
Dave - if Republicans take over the Senate, keep the House and win the Presidency, they can rewrite a preponderance of the ACA and, for lack of a better term, choke off funding mechanisms to states for Medicaid and health insurance exchanges. A Republican president could also have his HHS and CMS people rewrite or terminate regulations ushered in after the ACA was passed. The House GOP could try to starve the programs/initiatives now but it would be more window dressing than anything. The automatic appropriations are assumed because there is not much of a way to fully (or even partially) defund the initiatives set forth in the ACA.
Comment by Team Sleep Wednesday, Sep 14, 11 @ 2:23 pm
**Dave - if Republicans take over the Senate, keep the House and win the Presidency, they can rewrite a preponderance of the ACA …**
Correct… which is why I said that the ACA wouldn’t be changed/defunded unless Republicans controlled Congress (meaning at least 60 votes in the Senate).
Comment by dave Wednesday, Sep 14, 11 @ 2:48 pm
The money to keep Medicaid afloat has to come from somewhere, folks.
Rich fat cats? China? Capitalist pigs?
I know you think that Illinois businesses and their rich owners won’t leave the state and will cough up more dough if the taxes are raised but what happens if China backs off of buying our treasury notes or has its’ own recession/depression and can’t buy anymore?
To balance the needs of our neediest against the need to foster business growth is not an easy task. Besides, I don’t think MJM would allow a tax increase bill to clear a committee let alone get voted on in the whole house.
It is easy to toss out slogans about the wars, media tycoons and health care providers - “Big Pharma” is a favorite target. Tougher to acknowledge that the problem is more complex than that. How do we deal with more and more folk being dependent on the gov’t for day to day needs - investors coping w/the regulations of multiple agencies just to try to start a business that could employ many - subsidies for farmers, corporations w/clout from both sides of the aisle? How do we correct the problems created by a housing crisis fueled, in part, by the easing of credit to folks who could not afford the mortgage coupled with the greed of some who made things worse?
We do that by demonizing those we don’t agree with and lay the responsibility for the collapse of our economy on the other political party.
Easy peasy.
Now what?
Comment by dupage dan Wednesday, Sep 14, 11 @ 3:03 pm
–It is easy to toss out slogans about the wars, media tycoons and health care providers –
It’s easier to see that the wars cost $10 billion a month. That’s on top of the “regular” defense budget that is more than the next 17 largest defense spenders combined.
That’s not tossing out slogans, that’s identifying real money.
Comment by wordslinger Wednesday, Sep 14, 11 @ 3:12 pm
A lot of people still seem to confuse and/or improperly compare Medicare and Medicaid
Comment by steve schnorf Wednesday, Sep 14, 11 @ 3:22 pm
The USA cannot continue to price protect big pharma profits under a fax banner of “free trade” causing Americans to bear the full burden of the Pharma’s R&D expenses for the rest of the world.
Why is it we ALWAYS seem to know to the exact penny the amount of money being spent for the people in or near poverty but there is never a total number of what is being spent on corporate welfare and bailouts and tax incentives and tax breaks for corporations.
Welfare is welfare — Giving a tax break handout to a corporation is the same as spending money that we don’t have.
Comment by Snj Wednesday, Sep 14, 11 @ 4:02 pm
Somewhat unrelated, but included because it annoys me and to focus a little on the positive: it’s easier to make a scary graph showing an enormous uptick in poverty when the graph is scaled from 11 to 16. That’s not to dismiss the problem nor the trend however.
Comment by ZC Wednesday, Sep 14, 11 @ 4:51 pm
Wildly accelerating expenditures for health care are killing this country, and sicne no one seems capable or willing to severely restrict the costs of health care, then we will ahve to live with the consequences. One of those consequences is that the health care system as we know it, Medicaid and Medicare included, will by scaled back or eliminated. The government is ultimately subject to the same economic facts of life that rule us all. Perhaps if the government stopped medical subsidies, the medical industry would find itself subject to the laws of the marketplace and would be forced to try for a more affordable system or go broke itself.
Comment by Skirmisher Wednesday, Sep 14, 11 @ 8:44 pm
This video predates Obamacare, but is one of the better presentations on health care policy that I’ve seen. If you’re like me and you aren’t a health care policy expert, this is worth a view. The whole presentation with Tommy Thompson is better, but Daschle really nails the issue well here.
http://youtu.be/ynHGSmeTito
Comment by 47th Ward Wednesday, Sep 14, 11 @ 9:56 pm