Ill-inois: Progressives Push Single-Payer Fantasy
States don't have what it takes to implement single payer
Illinois progressives have found a new way to prove the old rule: no bad idea ever really dies in a one-party state. It just gets recycled, renamed, and reintroduced as compassion.
The latest example is Senate Bill 2873, the “Health Care for All Illinois Act,” introduced by Sen. Mike Simmons. The bill would create a state-run Illinois Health Services Program covering all Illinois residents, establish an Illinois Health Services Trust to finance it, and make it unlawful for private insurers to sell coverage duplicating the state plan. In other words, it would not merely expand access to health care. It would effectively replace most private health insurance in Illinois.
The bill also says Social Security numbers would not be used for registration and that individuals presenting for covered services would be presumed eligible. This it would cover illegal aliens. It would fund the system through state appropriations, federal health care dollars, and “progressive” income-based contributions from individuals, businesses, and government.
This is not health reform. This is an attempted government takeover of one of the most complicated sectors of American life.
The idea sounds simple if you say it fast: everybody gets covered, the state pays the bills, private insurance goes away, and administrative waste disappears. But health care is not simple, and Illinois is not an island. Millions of people work for national or multinational employers with national benefit plans. Some live in Indiana or Wisconsin and work in Illinois. Some live in Illinois and work somewhere else. Many families have coverage through employers operating across state lines. Trying to impose a single-payer system on one state would smash into federal programs, employer plans, union contracts, Medicare, Medicaid, ERISA, hospital financing, provider networks, and plain old geography.
Vermont already tried the dream. It passed a single-payer-style plan, Green Mountain Care, and then abandoned it in 2014 when the numbers became politically and economically impossible. One analysis estimated the first-year cost at $4.3 billion, requiring billions in new state taxes. Former Gov. Peter Shumlin later admitted they were “pretty shocked” by the tax rates required.
That was Vermont. Illinois is vastly larger, vastly more complex, and already groaning under pension debt, Medicaid pressure, public-sector obligations, population flight, and a political class addicted to pretending arithmetic is optional.
The Illinois bill even goes beyond insurance. It would prohibit investor ownership of health delivery facilities, including hospitals, HMOs, nursing homes, and clinics, while compensating existing owners for loss of facilities but not for lost business opportunities. That is not merely a financing reform. That is structural socialization of health care delivery.
There are real problems with American health care. It is too expensive, too bureaucratic, too opaque, and too maddening for patients and doctors alike. But replacing one complicated system with a massive state-run monopoly in Illinois is not common sense. It is ideology dressed up as compassion.
The best argument against this bill is not that its sponsors are evil. It is that they are unserious. They are proposing to put the entire health care system of Illinois into the hands of the same political culture that cannot manage pensions, transit, schools, crime, budgets, or basic public order.
Before Illinois progressives promise to run everybody’s health care, they might first try running the state responsibilities they already have responsibly.