(Chicago) – In 90 days, 342,000 low-income Illinois citizens will have access to health care, including many of those involved in the Illinois criminal justice system who require treatment for mental health, substance use, and medical conditions.
On July 22, Governor Pat Quinn signed legislation, Senate Bill 26, that authorized Illinois’ participation in the new national health reform law called the Affordable Care Act.
As one of the outcomes of this legislation, starting on January 1, 2014, adults aged 19 through 64 with incomes below 138 percent of the Federal Poverty Level (about $15,400 per year for an individual and $20,000 per year for a couple) will gain access to Illinois Medicaid coverage.
What this means is that uninsured, low-income adults—describing the majority of individuals in Illinois jails and prisons—will have greater access to treatment for substance use and mental health conditions that often contribute to their criminal behavior. Eighty-six percent of male arrestees in Cook County, for example, test positive for illicit drugs. Nationally, about a quarter of people in jail convicted of property and drug offenses had committed their crimes to get money for drugs.
In addition to improving treatment access for low-income populations, the new law also answers a resounding public call: A Cook County referendum on state funding for substance abuse treatment passed overwhelmingly in 2004, with more than one million voters saying the state should pay for drug and alcohol treatment for any Illinois resident who demands it.
A long time coming, the new health care law begins to answer this public demand by providing the means to fund treatment programs.
Under the legislation, the federal government will pay 100 percent of the costs of the new Illinois Medicaid enrollees from 2014 through 2016. Starting in 2017, the match rate gradually will be reduced: 95 percent in 2017; 94 percent in 2018; 93 percent in 2019; and 90 percent in 2020.
The share paid by the federal government for care in Illinois will never dip below a 90 percent.
Even if the federal government were to change the law’s financing terms, Illinois’ share would never be more than 10 cents on each dollar spent on new Medicaid recipients. The legislation signed by Quinn includes language that would discontinue coverage if the federal government’s share of Medicaid matching funds drops below 90 percent.
Illinois currently receives a 50 percent match from the federal government for health programs under terms of the existing Medicaid program.
For individuals involved in the Illinois criminal justice system, the Illinois Medicaid expansion is critical, because they will be able to access adequate medical care and, equally if not more importantly, behavioral health care such as substance use treatment and mental health care, many for the first time, according to TASC President Pamela Rodriguez.
“TASC strongly supported this legislation because rates of addiction and mental health disorders are disproportionately high in the criminal justice population. Access to care for these conditions can help break costly cycles of crime and recidivism,” said Rodriguez. “Additionally, the new health law will help save counties and the state of Illinois enormous sums of money on justice and uncompensated health care costs.”
Rodriguez pointed out that the national and Illinois record on Medicaid access has been solid, noting that “Illinois has received bonus payments totaling over $50 million over the past four years for meeting enrollment targets and having program simplifications in place for our Medicaid and Children’s Health Insurance Program.”
Additionally, Medicaid cost controls outperform both Medicare and private health insurance. Nationally, the per enrollee cost growth in Medicaid is 6.1 percent, which is lower than the per enrollee cost growth in comparable coverage under Medicare (6.9 percent), private health insurance (10.6 percent), and monthly premiums for employer-sponsored coverage (12.6 percent).
To help criminal justice organizations and agencies establish enrollment processes, the Substance Abuse and Mental Health Services Administration (SAMHSA) has launched an online toolkit entitled, “Getting Ready for the Health Insurance Marketplace.” This narrated presentation describes the health care law, explains how the Health Insurance Marketplace works, and provides communication ideas and materials from the Centers for Medicaid & Medicare Services (CMS) for use in increasing awareness and helping uninsured individuals apply for coverage.
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