>> Nearly 770,000 Illinois residents could lose their health coverage.

Democrats are sounding the alarm about Republican efforts to slash government spending, including Medicaid, the program that provides medical care to people who are low-income or have disabilities.

Nearly one one in 5, 1, in every 5 Americans, nearly one in every 5 Americans.

The GOP controlled House narrowly passed a budget last week that Republicans say could cut 2 trillion dollars from the federal budget over a decade.

Among those massive proposed cuts spending on Medicaid.

Here to talk more about the potential impact is Stephanie Altman, director of health care, justice and senior director of policy at Shriver Center on Poverty Law and Ted Dabrowski, president and CEO of Wire points.

Welcome to both and thank you for joining us.

Thank So, Stephanie, want to start with you, please.

How would a cut like this impact people who are on Medicaid?

would be absolutely devastating.

And as you said, 770,000 people could lose coverage within 90 days.

>> Of that federal funding dropping in Illinois.

And that program started in 2014 and it's provided its increased health coms.

It's improved people's lives.

It's allowed people to work.

And these are people who are mainly working and employed.

So it would also be very, very deep cuts, not just on that population, but on nursing home coverage for older adults.

Half of all births are covered by Medicaid and Illinois and absolutely devastate hospitals are safety net hospitals, hospitals in rural areas who are often the largest employer of people in their city.

These cuts are absolutely devastating and would really hurt the population, but also that economy of Illinois, our bond rating would probably go down and it really harm businesses as well.

You know, we'll get a little bit more of that as well.

Ted Dabrowski, we've spoken about federal funding Why do you think the federal government should rein in spending on Medicaid?

let's be cleared from everything I've seen I read is that that they're not going to cut spending.

They want to cut the growth in spending.

So.

>> Medicaid is expected to grow the next decade by 2.5 trillion.

They want to take that growth.

880 million of that growth.

So still grow by 1.5 trillion.

So still massive growth.

This is of the real promises these programs.

We talk a little bit before these federal programs are getting so big.

deficits are huge with 36 trillion dollars in and deaths that we got 150 trillion dollars shortfalls Medicare and Social Security.

And we have no plan of how to pay all that.

And, you know, it's it's always let's take a lower income.

People get hurt by all these squeezes and tax hikes and all that.

That's a big risk.

So I think we have to be careful, not ballooning these programs that bring them under control because if not people who lose the proposed reforms include reducing the 90% expansion costs that states received establishing a per capita grant.

>> What does that mean to it and what would the what do you think?

It's better than the current?

yeah.

So when we had the expansions was interesting that the federal government gave Illinois the chance to expand the number of people on Medicaid.

>> And they say that we pay for 9 out of every $10, right?

90%.

And so we made the mistake of thinking that we can take that money.

at a million new people onto Medicaid.

But now the federal government can't pay those 9 out of 10.

So now we're on the hook for that expansion.

And we made the mistake of of expanding Medicaid because we didn't have the funding for it.

If we if they do cut back on that 9 and make it 5, we've got to pay.

The other 4 are going to for Medicaid.

So that's that's the big struggle.

The we expanded too fast too much.

And now we have single able-bodied people on Medicaid that perhaps shouldn't be on So it's a it's we have a good look at it.

And when I'm president, had said that wasn't a mistake we made that was a promise the federal government made to us in the Affordable Care Act over 10, 11 years ago.

>> The federal government said we want you to expand people who are 19 to 64 and were never able to be on Medicaid before.

These are people over 60% are working.

They don't get health insurance through their jobs or they can't afford health insurance.

And part of what Medicaid does is make them able to be able to and pay taxes and the members of contributing members in the community, some others are, you know, taking care of very young children, but we are giving them health care because the federal government and 41 states have decided to that.

41 states didn't make a mistake.

41 states took that promise from the federal government and now the federal government wants to break that promise in order to pay for tax cuts for billionaires and corporations.

Right.

on most expenses, if 50, 50 share with the federal government.

So this was a 90 10 share now were trapped and Iowa state like Wisconsin didn't expand.

So they're not trap of this.

This massive problem here.

>> It's also important note.

I got a piece of paper here that's got a graphic and we used to have in in 2000 least have 1.4 million people Medicaid.

1.4 in Illinois.

Now we have 3.6 That's that's a 250% increase.

Its massive are sections.

A 2.5 times increased.

We have so many that we have almost 30% of our population on Medicaid.

Medicaid was supposed to be something for for the sick, the needy.

And now with with almost 3.6 million people, it's become a middle class entitlement, too many people are on it.

And that's why it's so expensive.

So want to you're going get you all and your Last week, members of the state's Democratic congressional delegation joined a had a joint press conference addressing the potential Medicaid cuts and how broad that impact could be.

>> It's also a broader economic issue.

Illinois hospitals and our health care systems and supports.

Of provide jobs for 445,000 people and they anchor many rural communities.

Hospitals will close.

People will lose their jobs.

>> And Stephanie, aside from people losing their jobs, how else might this impact the economy?

You mentioned credit rating, right?

It's, you know, Medicaid an economic driver.

It drives employment.

It helps people be covered so that they can work.

It helps employ people in hospitals medical centers.

It also is it there's mind, okay, funding in our schools.

There's no nursing home coverage for anybody under Medicare insurance.

Medicaid is the main pair of nursing homes.

It pays for over 50% of all births in Illinois.

And it's not a middle class benefit.

The people who the 770,000 that you're talking about, good lose Medicaid make under $19,000 a year.

That's not the middle class and they don't have access to affordable health insurance.

So it is really pervasive throughout our society and we're proud of the fact that Medicaid has grown that much.

That's part of what it was meant to to.

Do you think there's a possibility of of job loss if cuts like this where?

No, I think you I think we've got a bloated government.

We have to remember we said this before.

We have the highest property taxes in the country.

>> We have the 6th highest overall state and local tax burden.

We have the highest pension debts in the country by far we're deep trouble.

And so we can keep thinking that we can just keep putting money into government and government spends it.

Well, people leaving the state people leaving Chicago.

When you think the opposite.

We need to have we shouldn't have an economy.

We're nearly 30% of our economy is on Medicaid.

It's back with a and that with all due respect, I think it's the opposite.

We shouldn't be proud that we have 3.6 million people Medicaid.

We should have as few people as possible because our economy is so strong because people can earn a living and it's a sad state for Governor Pritzker.

When you say that to when he took office in 2019, there were 700,000 fewer people on Medicaid.

People weren't dying.

We didn't have a, you know, the kind of crisis he talking about because that's where we were before took office.

So I think we're overplaying this.

We need I'm much more efficient to look.

But May may just bring up one thing we had.

We just had this not report the inspector general report about this 1.6 billion and health care costs for for the illegal immigrants.

Nobody understood that cost.

Nobody just Coming up, Representative Debbie Ramirez 2 million it turns into 1.6 billion out of control in spending and we better start looking at it.

If not, we're going to pushing more people.

And it sounds like you think that it should be a health insurance of last resort for far fewer people.

But that were the case.

>> What is the alternative for ensuring?

No, I think should be.

we want a big risk and this many people are on the program.

So many people getting money that we don't take care of the poor.

And this is gets diluted.

We need to make sure that we're taking care of poor because that's what it's for.

I think 3.6 million people.

Maybe we shouldn't take care of billionaires and corporations and give them a tax break and we could provide health insurance to people who are working.

>> Over 60% of the people are working and only making up to $19,000 a year.

They have no ability through their employer to get health insurance or to pay for health insurance.

So I think we should.

This program is there just for that purpose?

>> It should be for those people and others, you know, like when when when Blagojevich expanded the program, he went to 4 times federal poverty level.

So we have a lot of we've so many people in and made so many exceptions.

We need to take care of the poor, the really the people that need it, we should make sure we take care of and the rest.

letter economy growing, help them.

All right.

We'll have to leave