Imagine making $1,366 each month — the Medicaid income threshold for a single adult. That’s akin to working about 32 hours a week at a minimum wage job in Chicago. How would you spend your money? If you live in North Lawndale, $720 in rent (the average cost for a one-bedroom apartment) would take more than half of your salary. Allocate another $160 to $200 for food, according to the U.S. Department of Agriculture. Need transportation? A 30-day CTA pass will set you back $100. And then there are utilities and other housing necessities, a phone, clothing. Where would health insurance fit into your monthly budget?
Employment, while critically important, does not eliminate the need for government-sponsored health insurance programs. Approximately 60 percent of adult Medicaid members work, more than half working in excess of 40 hours a week. Eighty percent live in working families.
Medicaid is a lifeline for 1 in 4 Illinoisans, many of whom are often referred to as the “working poor.” The income threshold for Medicaid coverage is excruciatingly low. Full-time, low-wage jobs rarely come with insurance, much less a salary to cover one’s basic expenses. Job training and other support programs would be much-welcomed but far from a silver bullet.
Earning $1,366 per month qualifies a person for Medicaid, but what about someone making $1,367? That person must find her own health insurance on the marketplace, likely at a premium, or go uninsured. An eligibility line has to be drawn for practicality, but in the real world it is painfully arbitrary.
Today, the future of the nation’s social support programs, especially Medicaid, looks bleak. Of the “reform” solutions being debated, one would do more harm than the last, stripping essential health coverage from those most in need. In Illinois, we spend less per Medicaid enrollee than any state in the country, and way below the average amount spent for each American on health care. This low starting point would serve as a baseline for federal block grants or per capita caps, putting Illinois at a serious disadvantage and reducing the funding available to our state.
If proposals like these move forward, expect to see a reduction in services, diminished payments to Medicaid providers and barriers to enrollment, even in times of economic recession.
Eliminating health coverage for millions of Americans may be pennywise, but pound foolish. A healthy workforce is critical to a healthy economy. With insurance, employed Medicaid members are better able to get the health care they need to stay well and continue working to contribute to our society and better their family’s financial position.
If we want to diminish the need for Medicaid, let’s take actions that strengthen household income, and stop punishing those left behind by our increasingly inequitable economy.
Dr. Jay Shannon is CEO of Cook County Health and Hospitals System.