Medicaid cuts would be 'devastating,' advocates tell Illinois House panel

SPRINGFIELD — Ever since she was diagnosed with Stage 4 cancer in 2018, the Community Care Program has been a lifeline for Diana Inman.

The program helps older adults who might otherwise need to move into a nursing home to remain in their homes, by providing in-home and community-based services.

The 75-year-old Decatur resident receives the services through Medicaid, the nation's health insurance program for more than 70 million people with low incomes and disabilities.

"I have an active case worker who regularly checks up on me, and I've received regular cancer treatments at least every three months," Inman said. "I have a dedicated home health aide to help me three times a week for the household chores."

Cuts to Medicaid would be "disastrous" for people like her, she said.

"Speaking from personal experience, if I were to lose my health coverage though Medicaid, I would probably be forced to sell my home just to cover a year's worth of my medical expenses," Inman said. "And then where would I be?"

Inman was one of several Medicaid recipients, hospital executives, insurance industry officials and mental and behavioral health advocates who testified before an Illinois House budget committee hearing on Wednesday about the significant impacts that would be felt across Illinois if the program were cut.

One by one, they painted a picture of a health care ecosystem that would essentially collapse with up to 770,000 Illinois residents at immediate risk of losing their coverage, safety net hospitals in rural and urban areas on the brink of closure and critical services being cut.

"The hospital community is deeply concerned with the size and scope of these proposed Medicaid cuts and their impact on access to health care services across the state of Illinois," said AJ Wilhelmi, the president of the Illinois Health and Hospital Association.

The two-hour hearing was just over a week after U.S. House Republicans approved a budget framework that calls for more than $4.5 trillion in tax breaks that would disproportionately benefit the wealthiest Americans and $2 trillion in spending cuts largely to social programs.

The resolution directs the House Energy and Environment Committee to come up with $880 billion in cuts over the next decade to programs it oversees, which include Medicaid.

While it does not specifically call for cuts to Medicaid, several state legislators said it is likely next-to-impossible to achieve the level of cuts outlined without touching the program.

More than 3.4 million Illinois residents receive health care through Medicaid, including 772,000 covered under expansion through the Affordable Care Act.

Lizzy Whitehorn, the director of the Illinois Department of Health and Family Services, the agency oversees the state's Medicaid program, told lawmakers the state received more than $20 billion from the federal government in 2024 for Medicaid, accounting for about 62% of the program's cost.

Of that, about $7 billion is for expansion, which has a higher 90% federal cost share. Illinois has a trigger law that would automatically end coverage if it dips below that percentage.

Whitehorn said Illinois would likely lose between $24 billion and $39 billion in federal funding over 10 years under one scenario being considered by federal lawmakers.

"I want to emphasize that every proposal Congress is considering to cut Medicaid costs will result in health care coverage losses in Illinois," Whitehorn said.

Democratic lawmakers who dominate the state legislature acknowledged there is very little they can directly do to affect federal Medicaid funding. But the potential for deep cuts has created significant uncertainty as they seek to craft a state budget this spring. Medicaid spending accounts for about 35% of the state's all-funds budget and about 17% of its general fund budget.

They used the hearing as a clarion call to Illinois' three congressional Republicans, urging them to protect the program from the deep cuts they say will hurt their constituents.

"The Republicans Illinois sends to Congress have the power to do something about it," said state Rep. Robyn Gabel, D-Evanston. "As mentioned, Darin LaHood, Mike Bost and Mary Miller need to see their statehouse colleagues speaking plainly and honestly about how the Trump agenda affects their communities."

"Because if they stand up for their communities, they can stop the most destructive plans denying health care for everyday Americans in our country," she said.

According to state data, more than 196,000 of Bost's constituents, nearly 181,000 of Miller's constituents and more than 139,000 of LaHood's constituents are Medicaid recipients.

All three voted for the budget resolution, which was procedural and not the final package.

Spokespeople for Bost, LaHood and Miller did not immediately return requests for comment.

State Rep. Bill Hauter, R-Morton, a medical doctor, acknowledged the cuts would be "devastating" if they take place, but he called the hearing "performative" in nature. He also said Democrats were ignoring the existing problems with the program, such as low reimbursement rates.

"I look at this program and I've already seen the cuts," Hauter said. "And so this, I think, is performative. We don't know what will happen. There's a lot of things that we have no control over. And I think we were here today as a performative exercise to say 'Trump is bad and we're going to lose the Medicaid system.'"

But Democrats took exception to that characterization.

"I just want to say to you, in earnest, this is not performative," said state Rep. Lindsey LaPointe, D-Chicago. "... We're trying to raise the alarm to the three congressional GOP members here in Illinois. We can't take for granted that they know about the $21 billion that the feds send to Illinois every year for Medicaid."

"So we are performing, I guess, for that audience, so they make sure that we can continue to have access to Medicaid in Illinois and in other states," she said, referring to the Illinois GOP members of Congress.

Inman, the 75-year-old cancer patient, said the uncertainty is weighing heavily on her and her family.

"Choices made by lawmakers in Washington have put the future of Medicaid in jeopardy, and as a result, lives are on the line," she said.