Illinois' headaches with its out-of-control Medicaid spending are just a taste of what's ahead with the federal Affordable Care Act, aka Obamacare.
Nursing homes and their residents are protesting Illinois Medicaid spending cutbacks -- cuts that were supposed to save the state $1.6 billion but actually are about $464 million less than that.
Obamacare counts on states expanding eligibility for Medicaid, but Illinois and more than half the states haven't committed to doing that yet, primarily because of the potential costs.
The federal government would fully fund the expansion the first three years, but then what?
Nursing homes say that Illinois already owes them $400 million and are on average six months late in paying. They understandably fear that an expansion, while it would give more people coverage, would make a bad fiscal situation even worse.
Obamacare is also counting on states to run their own health care exchanges, and Illinois will have one, but 33 other states have opted out. That puts pressure on the federal government to fill that void. Even the Democrats admit it's going to be tough. President Obama warns of a rocky rollout. Sen. Max Baucus, a chief sponsor, said he fears "a huge train wreck" unless preparations are stepped up.
We're not so much worried about the start as the rest of the story. The goal was to create a safety net so everyone could obtain health care. What is shaping up instead is that people will be falling through new cracks, many people will pay higher premiums than they currently do and coverage will be watered down. Obama's promise that people will be able to keep their current health care if they like it simply isn't true.
A Stanford University professor, in a column in The Wall Street Journal, estimates that 30 million to 40 million people will be damaged in some fashion by the new health care law. Few people are prepared for that.
There's a popular saying: No pain, no gain. In this case Americans will definitely feel more pain, but it won't be the healthy, productive kind.