SPRINGFIELD — Illinois inmates who will soon get out of jail won’t pass “Go” and get $200, but they may collect their Medicaid card.
A new plan working its way through the Illinois statehouse would start the enrollment, or re-enrollment, process for inmates 30 days before their release through the state’s Obamacare office.
State Rep. Camille Lilly, D-Chicago, is sponsoring the legislation that would have Illinois’ Department of Health Care and Family Services enroll inmates automatically upon their release.
“You cannot get Medicaid in a state prison,” Mark Heyrman, a University of Chicago professor and advocate for Mental Health America Illinois, told lawmakers last month. “The Illinois Department of Corrections is paying for every nickel of your health care, including your mental health care. It is illegal to bill the federal government for that.”
But once inmates are free, it is in Illinois’ best interest to enroll them into Medicaid, where the feds pay the freight.
Illinois’ prison system released 30,083 people last year: more than 27,000 men and nearly 2,500 women.
Women, particularly single mothers, have long been eligible for Medicaid in Illinois. But thanks to Illinois’ Medicaid expansion as part of Obamacare, young, single, low-income men also are eligible.
“Before the passage of the Affordable Care Act and the Medicaid expansion in Illinois, 90 percent of the people going in and out of the criminal justice system neither had insurance nor were eligible for Medicaid. Now more than 90 percent will be eligible,” Heyrman said, adding that making sure mentally ill inmates are enrolled in Medicaid is the “most efficient” use of Obamacare in Illinois.
Help is needed
Illinois had 47,962 people in prison as of March 31, and the DOC says about 23 percent of them are being treated for mental illness.
Forty-seven percent of inmates who are released will return to prison.
Lilly said last month some inmates end up back in prisons because that’s the only place they receive treatment.
“Since there is not a current system of ensuring medical coverage upon release, many people discontinue their medications and treatments … Such a gap in coverage is one of driving the forces for the high recidivism rate in Illinois,” she told fellow lawmakers.
It is expensive to keep someone, particularly someone who is mentally ill, in prison.
The budget for prisons in Illinois tops $1 billion, and estimates put the per-inmate cost between $25,000 and $38,000 per person. Illinois spent $146 million on prison health care alone last year.
Illinois’ empty piggy bank
Adding more people to Illinois’ Medicaid system could swamp an already costly program.
In 2000, Illinois had approximately 1 million people on its Medicaid rolls. Today there are more than 3 million enrollees, including 534,200 young, able-bodied, childless men.
Those men are Obamacare enrollees, and their numbers are growing. DHFS expects 650,000 young men to be enrolled in Medicaid by July 2016. That would dwarf the 445,700 disabled adults and senior citizens on Medicaid.
“The Medicaid expansion is already over budget. Last year alone, the Obamacare expansion cost taxpayers $788 million more than the Quinn administration projected. Nearly twice as many able-bodied adults have signed up as the state thought would even be eligible,” said Jonathan Ingram, research director for the Foundation and Government Accountability. “Enrollment has exploded, costs are soaring, and now some state lawmakers are proposing plans to make it grow even faster.”
Illinois will spend nearly $12 billion of state taxpayer money on Medicaid in the next budget; the federal match will push the total price tag to almost $20 billion. By comparison, Illinois’ total budget will be $31.5 billion.
Gov. Bruce Rauner has proposed cutting about $1.4 billion in Medicaid spending next year.
“Obamacare’s immoral funding formula creates a perverse incentive for states to protect the expansion at the expense of poor kids, individuals with disabilities, seniors and other truly needy patients,” Ingram said. “If the state wants to save a single state dollar in 2017, when we have to start paying our share of the costs, it has to cut either $2 from those who’ve always been part of the safety net, or $20 from the new class of able-bodied childless adults.”
Lilly’s prison plan is now headed for a vote in the full Illinois House.
Benjamin Yount is a reporter for the Illinois News Network.