LOL? There’s not much to laugh about in the Land of Lincoln, according to a poll released recently by Southern Illinois University. A whopping 84 percent of Illinoisans say the state is going in entirely the wrong direction, and almost half wish they lived somewhere else.

It’s hard to blame them. Illinois hasn’t had a full fiscal year budget in more than a year, and the stopgap budget enacted to cover the rest of 2016 came too late for the many social services agencies that have had to close due to lack of funding. Illinois’ $8.5 billion backlog of unpaid bills is expected to reach $10 billion by the end of the year. And the state has the worst credit rating in the country, according to Moody’s Investors Service.

Illinois’ poor fiscal state is affecting everyone along the spectrum of healthcare. The state owes some $3 billion to hospitals and physicians, filtered through the managed care companies that serve Medicaid and public employees. When receivables approach $100 million for one health system alone, as is the case in Chicago, it means that hospitals can’t move forward on plans to build, modernize, hire staff, or add new service lines. It means that small physician offices have a hard time paying utility bills, leading some to turn away patients on Medicaid and ask state employees to pay a greater share of their medical bills upfront. And it’s led one Medicaid MCO, Health Alliance, to pull out of the program, citing the uncertainty of what, how, or when the insurer would be reimbursed by the state.

Those not covered by government plans or private employers are faring no better. Residents shopping for individual health plans on the state exchange Nov. 1 will face an average 45 percent increase in their premiums. Networks will be narrower, meaning many will have to choose a new doctor. And they’ll have fewer plan choices from a dwindling number of insurers after the withdrawals of Aetna, Coventry, UnitedHealthcare, and Harken Health, and the failure of Land of Lincoln Health, the state’s CO-OP that enrolled nearly 50,000 people before falling victim to federal subsidy cuts.

 

The roots of Illinois’s fiscal problems are deep and long-standing. But it’s the vitriolic relationship between Republican Gov. Bruce Rauner and longtime Democratic House speaker Michael Madigan –called “The Real Governor” and “The King” of Illinois by Chicago magazine – that has lately hindered any compromise on spending and taxes. And the people of Illinois know it; both Rauner and Madigan get a thumbs-down from more than half the residents, according to the Southern Illinois University study.

Legislators say they’ll wait until after the general election Nov. 8 to take any action on the budget. With both Rauner and Madigan heading back to their offices, expectations are low. But crazier things have happened. The Chicago Cubs haven’t won a World Series title since 1908, and haven’t even played in it since 1945. But this year the Cubs have the best record in Major League Baseball and are 9-5 favorites among Las Vegas bookies to win.

And if the Cubs can actually move forward and win the championship, maybe anything can happen. Even an Illinois state budget.

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