Thursday, July 23, 2015

A Suit Saves 700,000 Impoverished Children in Cook County from Rauner


A decision handed down today by Illinois Judge Joan Lefkow makes even a hardened, cynical political observer hope in the power of a compassionate humanity.  

Lefkow’s order to the state’s Department of Healthcare and Family Services was for Illinois to make the necessary payments to the nearly 20 safety-net hospitals in Cook County which handle the disproportionate overload of Medicaid patients – especially children.

700,000 children.

The payments had been stalled or rendered unlikely due to the current budget impasse in Springfield.  Today’s court order follows an earlier decision from the bench requiring the Rauner administration to pay state workers in full during the fiscal stalemate. And a previous decision had been delivered ordering the Rauner administration to fund foster care operations, which were also identified as probable victims of the budget gridlock. 

In all cases, payments will come inescapably from the General Revenue Fund, where the “money is available,” according to Judge Lefkow, a magistrate of the Northern District 

The Sargent Shriver National Center on Poverty Law brought suit against the Department of Healthcare and Family Services, identifying past court orders, previous consent decrees, and federal mandates that guaranteed funding for services to aid the State of Illinois in reimbursing hospitals for medical assistance provided to the poor. 

Hospital CEO Timothy Egan of Roseland Community Hospital on the far south side explained that his institution was readying to close down in about a week prior to today’s decision.  Other hospitals were considering reduced services, lay-offs, or even the elimination of ambulance services.  

John Hoffman, spokesperson for Illinois’ Department of Healthcare and Family Services, who earlier opined that predicted increases in state Medicaid costs suggested how necessary it was for the state to get its “reckless” spending under control, now announced that the Department was reviewing the court order, one the Department believed was an incorrect interpretation of the original consent decree. 

The Shriver Center is considering an additional suit to increase the court decree beyond the boundaries of Cook County, unless Rauner is willing voluntarily to consider needs beyond the parameters of the original decision.  The Illinois Hospital Association Chief Government Relations Officer, A. J. Wilhlmi, encouraged the Governor to reimburse the entire state safety-net system, not just one county. 

Senate Leader John Cullerton reminded the Governor, who had earlier described Cullerton as an ally in his eventual creation of a budget solution, “if court mandates keep piling up and no spending plan is approved, Illinois state government faces a $4 billion deficit.  The governor’s office did not dispute that figure”

A recent sobering report by the Annie E. Casey Foundation reiterated the need for immediate support for the lowest income workers and especially their children.  The report, entitled Kids Count, looked carefully at the effects of the Great Recession of 2007-2009, the economic recovery of the disaster, and the current fiscal health of families relative to economic class prior and after the upturn.

“After numerous years of depressing economic news. Many positive trends signal that the economy is finally recovering from the deep recession…Nonetheless, there are warning signs that the recovery may be leaving the lowest income families behind, disproportionately affecting workers of color and their children…When very young children experience poverty, particularly if that poverty is deep and persistent, they are at high risk of encountering difficulties later in life – having poor adolescent health, becoming teen mothers, dropping out of school and facing poor employment outcomes.”

700,000 children in Cook County.

At the turn of this last year, the Pew Research Center found the gap between middle income and upper income families after the Great Recession is the widest ever recorded. 

Measuring total family wealth, PEW found that middle-income families in the 1990’s had accrued a median family wealth of nearly $94,000.  Now after the Recession, they had climbed back to a median average of $96,500.

Upper income families, on the other hand, had a median accumulated wealth of $338,500 in the 90’s, and a median total wealth of $639,400 in 2013.  Nearly doubling the overall financial cushion. 

But for the lowest income earners, the Great Recession was a brutal tsunami of fiscal disaster, one that left them on a far lower rung of the economic ladder than even before the Great Recession.  In the 1990’s, a low-income median family held a total worth of nearly $14,000; now after the Recession, a reduced total fiscal value of only $9,000. 

The Federal baseline earnings to qualify as "in poverty" in a four member family is $24, 250.

In Illinois, the threshold for Medicaid eligibility for children is now (under the Affordable Care Act) set at 147% of the Federal Poverty Guidelines: that is, 1.47 times $24,250 for a four-member family.

Thus, in Illinois, two parents and two children earning less than $36,375 become eligible for Medicaid assistance.

For a single mother with one child, that determination is approximately $23,000.

For a single mother with two children, the number increases to approximately $30,135.

Various research findings within the Annie E. Casey Kids Count study provide startling information about the possible benefits of governmental fiscal intervention for children in low-income or impoverished families.  "One study found that for families with annual incomes below $25,000, providing them with an additional $3000 during a child's preschool years was associated with a 17 percent increase in their earnings as an adult."

In Illinois, the majority of the poor population covered by Medicaid assistance are children: 57%.  On the other hand, those same children account for only around 26% of the costs of Medicaid, while the greater portion of medical costs remains used by the disabled and the elderly. In other words, children in poverty are the largest neediest recipient of assistance - over half, but the costs fall around 25% of all expenses. ( Medicaid Explained: How It Works & Why It’s So Important |

After Judge Lefkow's ruling, the families and parents of the 700,000 children that fall under these numbers in Cook County alone can seek employment and work knowing they have at least some financial protection against the risk of medical expenses.

It's a heartless world, and neither the Great Recession nor Illinois Governor Rauner's budget battle has helped. 

“In 2013, one of four children, 18.7 million, lived in a low-income working family in the United States.  This is 1.7 million more than in 2008.  And 27 percent of children in low-income working families are younger than age 6” (Kids Count).

Bless you, Judge Lefkow.

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