Since she was 5 years old, Champaign resident Jamilah Barbee and her family have relied on Medicaid to cover hospital visits at Carle Foundation Hospital — as well as her prescriptions, her dental care and regular checkups.
But as state and federal officials weigh potential funding reductions to the program, Barbee, now 21, worries about how far her coverage will stretch.
“My mom struggles enough as it is to put food on the table and keep the heat on, so there really is no room for more things to pay for if they stopped covering as much for it,” Barbee said in an interview with CU-CitizenAccess. “I honestly don’t know what I would do because that’s the support I would need for money I don’t have for that.”
Medicaid is a joint federal and state program that provides health coverage for people with limited income, children and people with disabilities to access care.
Earlier this year, Barbee was rushed to the hospital by ambulance after fainting at the gym due to low blood pressure. Without the support of Medicaid, she said she wouldn’t have been able to afford the emergency care that stabilized her condition.
Stories like Barbee’s illustrate what is at stake for working families, college students and children who depend on Medicaid for both emergency and preventative care across Champaign County.
55,958 enrolled in Medicaid in Champaign County during the year 2023.
Over 3.8 million residents of Illinois enrolled in Medicaid in the year 2023.
According to the Illinois Department of Healthcare and Family Services (HFS), Illinois receives more than $24 billion annually in Medicaid funding, covering over 3.8 million residents.
In Champaign County alone, just over one in five people — about 46,000 residents — receive coverage through the program.
Illinois funds its share through general revenue, hospital and nursing home assessments and other sources.
A March state policy brief outlined the potential impact if the federal government freezes or reduces Medicaid funding. The report estimated if proposed cuts were enacted, millions of dollars in approved federal match payments would no longer flow to Illinois providers.
Community health centers that serve 1.5 million Illinois residents could lose over 21,000 jobs, and hospitals and first responders across the state could face significant financial strain, the brief said.
In the state’s fiscal year 2024, Illinois’s Medicaid program paid $10.8 billion to hospitals, $3.8 billion to long-term care facilities, $4.5 billion to pharmacies and $2.1 billion to physicians and clinics, budget documents within the policy brief said.
Local Hospitals Could Be Hit Hard
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Proposed funding changes are expected to affect some hospitals more than others, particularly in regions with high Medicaid enrollment.
Champaign County has two emergency care hospitals and 11 clinics and medical facilities, six of which are owned by Carle Foundation Hospital. Of those, only a few accept Medicaid patients for all services, meaning residents who depend on the program already face limited options for care.
Picture taken from google street view
Carle Foundation Hospital, one of the main healthcare facilities in the region, is among one of the few hospitals accepting Medicaid in the area. As of 2024, Champaign County’s population was about 210,000, and 46,599 people were enrolled in various Medicaid comprehensive benefits programs as of July.
According to data on revenue sources from the Illinois Health Facilities and Services Review Board (HFSRB), 11% of Carle’s total in-patient and out-patient revenue comes from Medicaid reimbursements.
Carle declined an interview but provided a written statement to CU-CitizenAccess:
“Healthcare provisions in the budget reconciliation bill recently passed by Congress are broad, and it is widely anticipated that the impact on hospitals and health systems across the nation may be substantial. As we actively assess how these legislative changes may affect our daily operations and identify any necessary adjustments, we are unwavering in our commitment to be a trusted source of high-quality care across the region,” a Carle spokesperson said in October.
OSF Heart of Mary Medical Center, another major healthcare provider in Urbana, have made around $16 million in revenue from Medicaid in 2024
Officials from OSF Heart of Mary Medical Center have expressed similar concerns to Carle. In a October statement, OSF HeathCare Spokesperson Tim Ditman said:
“At this time, it remains somewhat unclear regarding how changes will ultimately impact hospitals and how and when the provisions will be implemented. Added work requirements and shorter redetermination periods are two immediate areas of concern, as this will result in people losing access to Medicaid.”
Ditman also said Illinois is expected to see an increase of Medicaid funding because of state legislation passed earlier this year — but said it will be “short lived” as the federal spending bill takes effect.
Rural and Regional Hospitals….likely to close or suffer losses?
Around one in seven Americans live in rural areas and rely on rural hospitals and health systems for essential care, according to the Office of the Assistant Secretary for Planning and Evaluation, the principal advisor for the federal health and human services department.
Rural hospitals tend to serve those who face more challenges getting access to health care, not only due to a lack of affordable coverage options but also geographical location and limited options for health care providers.
The July funding bill did include an additional $50 billion to help transform how rural health care is provided in all 50 states. But it is contingent on states developing and submitting state plans under the program — it’s not simply automatic funding.
Champaign County Health Care Consumers (CCHCC), a nonprofit organization that helps community members enroll in all forms of health insurance, including Medicaid, has been advocating for those who might lose coverage or benefits. In response to the program updates, the group has been communicating with elected officials on the impacts to local hospitals, helping people appeal benefit terminations and helping them find other options if they are no longer eligible.
A client coordinator for the nonprofit, Adani Sanchez, said many clients fear the uncertainty.
“It is not clear how the state will handle the changes, so we are just waiting to see what they do,” Sanchez said. “Clients rely on Medicaid for life sustaining medication, so changes in copays or services could mean having to choose between eating and taking medication. Many are on fixed incomes and do not have the wiggle room to absorb even small increases in costs.”
Barbee said that uncertainty was unsettling to her, living in a rural area where her options for care are limited and could be getting worse.
“It’s honestly insane. I’m fortunate enough to still be eligible but at this point I don’t know for how long,” Barbee said.