OP-ED: Revamping of Health Law Could Be Costly to Illinois

As Congress prepares to replace the Affordable Care Act, it is essential that the Medicaid expansion provision of the law be protected.

Any rollback of federal Medicaid coverage would be particularly harmful to Illinois, especially as our state grapples with budget deficits, an opioid epidemic, and an overburdened criminal justice system.

Under the ACA, Illinois was among the majority of states that expanded Medicaid, which provides federally-funded health insurance for low-income people. In a January letter to congressional leaders, the Rauner administration expressed concern about potential changes to Medicaid, pointing out that 3.2 million Illinoisans—almost one-quarter of the state’s population—are enrolled in coverage. 

Reducing Medicaid coverage would deprive Illinois of millions of dollars per year in federal support. As an example, in behavioral health services alone, the state would have to replace an estimated $80 million per year in federal Medicaid resources to pay for community-based substance use and mental health services that would support alternatives to incarceration and reentry initiatives.

Second, such changes would fly in the face of efforts to address the opioid epidemic that is devastating Illinois communities. Nineteen Illinois sheriffs, prosecutors, and police chiefs recently signed a letter to Congress urging action against any policy changes that would make it even harder for low-income individuals to access addiction and/or mental health treatment. Lack of treatment access impairs law enforcement’s ability to prevent overdose deaths and to make our communities safer.  

Finally, rolling back Medicaid coverage would hamstring Illinois’ successful bipartisan progress toward reforming the criminal justice system. Coverage for addiction and mental health services is essential to the state’s strategy for preventing crime, reducing recidivism, and avoiding the $41,000 per person annual average cost of incarceration for those whose non-violent offenses stem from untreated health conditions.

It is well recognized that there are aspects of the Affordable Care Act that must be overhauled. However, as changes are made, and to expound on what the Governor’s administration and criminal justice experts have written, it would be foolhardy and counter-productive if those changes include an attack on Medicaid coverage. Illinois can ill afford such a loss.

Pamela F. Rodriguez, President & CEO of TASC

TASC President Pam Rodriguez


Pamela F .Rodriguez is president and CEO of Treatment Alternatives for Safe Communities (TASC, Inc.) and a member of Governor Rauner’s Illinois State Commission on Criminal Justice and Sentencing Reform.

Researchers to Study Impact of Affordable Care Act on Public Safety; Cook County Key Research Site

(New York)Laura and John Arnold Foundation (LAJF) has announced a grant to a team of researchers at Johns Hopkins Bloomberg School of Public Health and Harvard Medical School to study the Affordable Care Act’s (ACA) impact on public safety.

The project will examine innovative programs focused on providing formerly incarcerated individuals with access to medical, behavioral health, and social services under the Affordable Care Act (ACA).

“Our aim is to identify possible links that may help to explain whether improved access to health care can contribute to a reduction in crime,” said Haiden Huskamp, a professor in the Department of Health Care Policy at Harvard Medical School. Dr. Huskamp is leading the study along with Colleen Barry, an associate professor and associate chair for Research and Practice at Johns Hopkins Bloomberg School of Public Health.

An inventory will be produced as part of the overall Hopkins/Harvard study and will be available at the end of the calendar year. The research will include an in-depth study of a unique partnership in Illinois between the Cook County Health and Hospitals System, the Cook County Sheriff’s Office, and TASC (Treatment Alternatives for Safe Communities), with the location being inside the Cook County Jail where thousands of individuals who are exiting the jail have been signed up for Medicaid coverage.

People involved in the criminal justice system often have extensive health care needs. More than two thirds of jail detainees meet clinical criteria for substance dependence or abuse, and 14.5 percent of men and 31 percent of women entering jail have a serious mental illness. Yet, studies find that the overwhelming majority of people leaving jail – 80-90 percent – do not have health insurance. New health care options under the ACA will allow many of these individuals to receive coverage.

“The goal of this project is to learn everything we can about how the ACA is being used nationally to make our communities safer and to improve public health,” said LJAF Vice President of Criminal Justice Anne Milgram.

Dr. Barry emphasized the importance of conducting in-depth studies of earlier innovator programs that are currently enrolling individuals exiting jails and prisons in Medicaid under the ACA, and developing ways to connect them to mental health, addiction, and other medical and social services in their communities.

“Early programs like the Cook County partnership have the potential to improve population health and may lower crime, so it is essential to learn lessons from their experiences and to share insights with jurisdictions in other areas of the country considering initiating similar efforts,” said Dr. Barry.

Research findings will be published in a peer-reviewed journal within the next year.