Fiscal Focus

              In This Issue:
• AUGUST 2010 ISSUE •
The stated intent of health care reform accord-ing
to its advocates is to close the divide
between those who have health care insurance
and those who do not. MostAmericans receive
their coverage either through government pro-grams
for the poor, disabled, and elderly,
through their employer, or through self pur-chase.
However, an estimated 12.9% of the
population (15.4% nationally) does not have
coverage in Illinois. Given the expense of cov-erage,
many individuals who would like to
purchase insurance, but are not covered by
government and employment programs have
to forego the purchase and hope that they are
able to avoid major medical
expenses.
The federal Patient Protection
and Affordable Care Act
(PPACA), signed into law on
March 23, 2010, opens the possi-bility
of affordable insurance
coverage to the wider popula-tion.
State government will play
a key role in implementing this
national initiative. Among other
changes, the state/federal health
insurance program (Medicaid) for low income
and disabled individuals administered by Illi-nois
will be expanded. Additionally, the law
calls for the creation of health insurance
exchanges to provide a centralized source
where individuals and small businesses can
purchase qualified insurance coverage. The
states are to establish these exchanges. Illinois
insurance regulators will be responsible to
make sure insurance providers meet the terms
of PPACA.
The changes embodied in PPACA are massive
and cannot be implemented immediately. The
transition to full operation of PPACA is not to
be completed until 2014. Transition provisions
will provide partial protection to the uninsured
during the interim period. Illinois’ state gov-ernment
will have an active role in administer-ing
these transition provisions.
To the extent that the crux of the health care
crisis is the high cost of providing health care
in the United States, there is concern that
expanding the insured population will increase
the demand for health services and further
ratchet up health costs. The success of PPACA
depends on the ability to provide more health
care without raising prices. Illinois health care
officials will help implement the cost control
measures to make PPACA workable.
Medicaid
Illinois currently provides Medicaid coverage
to low income pregnant women, jobless/work-ing
parents, infants, and children up to age 19
at various thresholds relative to the federal
poverty level (FPL) (see table above).
Cover Story....................... front cover, 3–4
Letter From The Comptroller................... 2
Illinois General Obligation
Bond Ratings........................................ 2, 7
Health Insurance Coverage................... 5
Ramped Up Capital Spending
in Fiscal Year 2010 Follows
Surge in Bond Sales............................... 6
Funding the New Capital Plan........... 8-9
Illinois ARRA Revenues
and Expenditures .......... 10-11, back cover
A Publication of the Illinois State Comptroller
Fiscal Focus
Impact of the Patient Protection and
Affordable Care Act on Illinois Government
Cover Story continued, page 3
l i d d h bili id h l h
Medicaid Coverage in Illinois
Before and After Reform
% of Federal Poverty Level (FPL)
Before Reform After Reform
Pregnant Women . . . . . . . . . . . . Up to 200%. . . . . . . Up to 200%
Jobless/Working Parents. . . . . . Up to 185%. . . . . . . Up to 185%
Infants . . . . . . . . . . . . . . . . . . . . . Up to 200%. . . . . . . Up to 200%
Children 1-19 . . . . . . . . . . . . . . . Up to 133%. . . . . . . Up to 133%
Childless Adults . . . . . . . . . . . . . . . . None . . . . . . . . . Up to 133%