Illinois pushes Cook County Medicaid plan

Associated Press
Updated 1/31/2012 6:37 PM

Illinois is asking the federal government to allow an early expansion of Medicaid coverage to low-income childless adults in order to bring millions of federal dollars into the struggling Cook County health system.

Illinois Department of Healthcare and Family Services Director Julie Hamos sent a letter Monday to the U.S. Department of Health and Human Services supporting the proposal and asking for an expedited review.


Any change would require state lawmakers to lift a freeze they put on Medicaid eligibility expansion last year.

The Cook County Health and Hospitals System collected only $190 million in patient fees last year when it was expecting nearly twice that amount. County health system officials estimate expanding Medicaid would cover 100,000 currently uninsured patients a year who already receive care, bringing in federal matching dollars now unavailable. Only legal residents would be eligible.

Medicaid costs generally are shared by the federal and state governments. But the proposed expansion wouldn't use state money because Cook County pays its share of Medicaid.

"We are thankful and looking forward to approval" from the federal government, said Dr. Ramanathan Raju, the county's new health system chief, who has been pushing for the expansion.

It's unclear what would happen if the expansion isn't approved. Cook County health system spokeswoman Marisa Kollias said the system "would never turn a patient away." The county already converted a suburban charity care hospital into an outpatient center last year because of financial difficulties.

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Hamos' letter seeks a waiver under the Affordable Care Act to move up the date of expanded Medicaid coverage for Cook County. In 2014, under President Barack Obama's health care overhaul, Americans who earn less than 133 percent of the poverty level will be eligible to enroll in Medicaid. States will receive 100 percent federal funding to cover the expansion for the first three years.

Illinois lawmakers placed a moratorium on expanding Medicaid eligibility last year as part of a Medicaid reform package.

"I do need to inform you that the Illinois law currently on the books will need to be altered before this waiver request can proceed under the contemplated timeline," states Hamos' letter to HHS.

Hamos said it will be up to Cook County to convince state lawmakers. "They're going to have to really reach out to the legislature," Hamos told The Associated Press. "They'll have to explain why this is important."

Five other states and Washington, D.C., have expanded Medicaid early under the Affordable Care Act, according to the Kaiser Family Foundation. The states are Connecticut, Minnesota, California, New Jersey and Washington, said Samantha Artiga, a Kaiser Family Foundation analyst.


AP Medical Writer Carla K. Johnson can be reached at

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