CHAMPAIGN — Federal funding for Medicaid, the federal-state health insurance program that covers more than 70 million lower-income Americans, could be on the chopping block. Clinics that provide free or reduced-cost care to residents of east-central Illinois are preparing for the possibility that a need for their services will spike if Medicaid faces cuts.
Republican lawmakers have set a goal of slashing $2 trillion dollars in federal spending over the next decade, which won’t be possible without steep cuts to Medicaid, according to a report released Wednesday by the nonpartisan Congressional Budget Office (CBO).
These cuts would potentially jeopardize health coverage for many children, people with disabilities and seniors, who are among the primary demographics for Medicaid, said Jeffrey Trask, founder of Champaign County Christian Health Center.
The bulk of Medicaid spending covers “people with disabilities, children and elderly people who are dual-eligible for Medicare and Medicaid,” Trask said.
Trask, and others who work for health clinics that provide free and reduced-price care in east-central Illinois, worry that Medicaid cuts will lead to an influx of people seeking care at their clinics.
Nick Nguyen, a medical student at Carle College of Medicine and volunteer at Avicenna Community Health Center, said Avicenna is preparing for this possibility.
“All free clinics will be very important for healthcare in the future if there are more people that have limited insurance, that are underinsured or uninsured,” he said. “Free clinics will “see more patients that may need a higher level of care that we can’t provide, but we will do the best we can to address the needs they have.”
Clinics like Avicenna and CCCHC do not rely on federal funding, since they receive private donations and state grants, according to Trask and Nguyen. But for larger hospitals in the area, like Carle Health and Promise Healthcare, Trask said cuts to Medicaid and other federal programs will have a greater direct impact.
“It’s also going to put a strain on our local hospitals…particularly federally qualified health centers like Promise [Healthcare] that relies on Medicaid quite a bit, as they get an enhanced Medicaid reimbursement rate,” Trask said.
Trask also worries that people who miss out on primary and preventive care will be more likely to end up in situations requiring emergency medical care. Champaign County Christian Health Center is planning to expand its services, adding a new location in Urbana, which Trask said could help them meet an uptick in demand.
Avicenna would like to do the same, but Nguyen said the main challenge will be finding enough volunteer medical staff to expand their hours and services.
State officials in Illinois are also bracing for the impact that steep federal funding cuts could have on the more than 3 million Illinois residents who are covered by Medicaid and its related Children’s Health Insurance Program (CHIP). The state relies on federal funding for two-thirds of its total spending on Medicaid, according to Lizzie Whitehorn, director of the Illinois Department of Healthcare and Family Services Director.
“Federal cuts would mean we have to limit services or eligibility,” Whitehorn said at a news conference this week. “And we don’t have the money as a state to make up the difference.”
Other developments at the federal level since President Trump took office in January have also impacted people’s access to care.
Hours after Trump’s inauguration in January, he announced rollbacks on a long-standing policy that prevents federal immigration agents from making arrests at or near sensitive locations, including hospitals and health centers.
The move, coupled with the recent uptick in ICE raids, has led some immigrants to skip appointments or disenroll themselves or their children from federal programs like Medicaid — something that Chris Garcia witnessed during the first Trump administration.
Garcia is a social worker with Champaign County Health Care Consumers, a nonprofit organization that helps people find low-cost health care resources.
“In 2016, we went through the same thing,” he said. “And there was kind of a slow decline and people just not [re-enrolling for] their benefits.”
Trask said he has not noticed people skipping their health care visits at his clinic due to concerns about immigration. But it’s something he said is affecting bigger cities where ICE raids have been more common.
The “Illinois Association of Free and Charitable clinics, which is a statewide organization that networks all the free and charitable clinics across the state, has seen a major problem with some of our clinics, particularly in the Chicago area,” Trask said.
Garcia said he’s waiting to see what Congress does next before making any moves. For now, Champaign County Health Care Consumers is staying focused on protecting current programs from possible ripple effects that could result.
“We’re on the defensive right now, trying to fight for keeping what we’ve got so far,” he said. “If there are small, incremental changes we can do, we’re definitely trying to make those happen. But I think at least right now, the big picture is kind of keeping what we’ve got.”