Thank you to Senator Rauschenberger for providing a little more information on Judy Baar Topinka’s spending and revenue proposals. But it still doesn’t add up. Taxpayers need to know how Topinka calculates her proposed revenues and cuts, rather than just taking her guesses at face value, and how much is she really going to invest in education and health care. Unfortunately, the Senator’s response still does not present a clear picture of either the details of Topinka’s proposals or of how the spending proposals and the revenue proposals, when put together add up to a balanced budget in each of the next four years. This stands in clear contrast to the Governor’s budgets, which have won national recognition in consecutive years for being clear and complete by Government Finance Officers Association.
More information helps citizens make an informed judgment about the competing priorities of the candidates, and it also exposes the real problems with Topinka’s budget analysis. Unfortunately, many of Senator Rauschenberger’s comments show the same flaws as Topinka’s plan. The comments, and the Plan, misleads taxpayers, relies on inflated revenues and unrealistic assumptions, and shows continued policy flip-flops.
1. Education
Misleading Taxpayers. If the Topinka budget plan assumes including teacher pension spending in its “education†spending, it is misleading. It provides school districts with an inaccurate estimate of how much they can expect to receive from the State, and claims money for education that actually will be used to pay interest on pension payments prior administrations failed to make. In addition, Topinka has said that she would spend more on schools than the Governor. To the extent that her plan would spend $8.2 billion and also pay for the pension costs of teachers, this is impossible. She should come clean about her spending plan – you can’t say that the same money is going to both pensions and schools, you can’t spend the same money twice.
2. Property Tax Reimbursement
Misleading Taxpayers. Topinka’s property tax proposal continues to mislead taxpayers and local governments. Despite the fact that Topinka claimed $2.4 billion in property tax relief, real tax relief based on historical property tax growth associated with schools from her proposal is only $1.8 billion over 2 years. Moreover, this spending binge will create a harsh hangover in 2010, as the first “unfrozen†school property tax bill will rise by an estimated $1.8 billion, which will be three times as much of an increase as the current property tax our taxpayers have been paying. As the Chicago Sun-Times noted yesterday, “her proposal is akin to pulling a drowning victim into a leaky boat: It merely prolongs the inevitable.†(See: Richards, Cindy “Neither school plan deserves an ‘A’†Chicago Sun-Times 8/30/2006)
3. Cutting Healthcare
Misleading Taxpayers. There is no reason why “Medicaid math†would work differently than ordinary arithmetic. Medicaid eligible individuals are real people who receive healthcare, and the State pays hospitals and doctors based upon the rates they charge, then gets reimbursed by the federal government. To cut these costs, you have to serve fewer people or reduce the rates that hospitals and doctors are paid, or both. Simple math. And if you do this math, you realize over four years 450,000 children, 275,000 parents, or 100,000 seniors could lose needed medical care.
Unrealistic Assumptions. The Topinka plan shows no detail on how these savings will be realistically achieved. But there is one reason that these cuts can’t occur immediately: moving to a block grant requires federal approval, and this takes time. This means that the cuts won’t be achievable in 2008, which means that actually the State would need to cut Medicaid spending by nearly $1 billion- with a B- each year to meet the Treasurer’s claimed targets. Because of federal reimbursement, described below, this means that actual services provided will have to be reduced by as much as $2 billion a year (a quarter of the size of the current Medicaid program). To achieve the savings Topinka claims, the plan also assumes no growth in healthcare costs while this approval process occurs.
Unlike the Topinka plan’s lofty assumptions, the only real solution to controlling healthcare cost increases is to implement realistic cost-controls, like prescription drug controls that are working now, and the primary care case management and disease management managed care initiatives that the Governor has implemented this year, leading to liability growth of 4.4%, significantly lower than historical averages, or what Topinka would have you believe. Republican Governors had 25 years to implement statewide managed care- we’re doing it after just 3 years.
4. Lost Federal Revenue
Senator Rauschenberger notes increased federal receipts from a block grant. The Topinka plan does not provide substantiation for this in its materials, and there is no basis to believe that total federal reimbursements would increase under a block grant. The Bush Administration has been trying for the past three years to significantly reduce State Medicaid funding, not increase it, including recently reducing funding for special education to Illinois schools. In fact, Topinka’s support of block grants (like the Medicaid Block Grant Program President Bush announced in 2003) will reduce federal revenues to the State significantly- which is the Bush Administration’s goal, less money for healthcare, not more. For an example of a non-partisan analysis of California’s attempt to move to a block grant, (See:
http://www.cbp.org/2004/0407medicalrestructure.pdf).
Misleads Taxpayers. Illinois receives 50% reimbursement from the Federal government for most medical services it pays for. Under a block grant, this federal reimbursement will disappear, and by making cuts, our reimbursement would also be reduced, by nearly $500 million a year. It is misleading to suggest that moving to a block grant will allow spending cuts that will offset this lost revenue, in fact such cuts would have to be twice as deep.
Unrealistic Assumptions. In addition, block grants do not allow for intergovernmental agreements or assessments, and the Topinka plan is proud to eliminate this revenue. The assumption that the federal government will replace these revenues is unrealistic. Eliminating transfers and assessments will cost the State and its healthcare providers in the following ways, with a total cost to Illinois (and its healthcare providers) of more than $1.3 billion. The Topinka proposal indicates that it will get rid of these revenues:
Cook County IGT- The State receives $317 million in 2007 from this transfer, and Cook County receives approximately $270 million from this transfer. The State and the County would have to find ways to make up for this lost revenue.
Hospital Assessment Tax - Illinois generates over $600 million from this assessment, of which Illinois Hospitals will receive almost $500 million, GRF receives $80 million, Illinois Nursing Homes receive $40 million and the Illinois developmentally disabled community receives $40 million.
University of Illinois IGT - The State and the University of Illinois share the $48 million that this transfer generates.
DD Assessment - Illinois developmentally disabled community receives an additional $40 million as a result of this assessment. Though GRF is not impacted by the assessment, this will leave a hole in community funding that GRF spending would need to be increased to replace.
Nursing Home Assessment - GRF receives $15 million and Illinois nursing homes receive an additional $30 million from this assessment.
5. Gaming
Flip-flop from Prior Position. Some of the details of Topinka’s gaming plan have only recently been received. While $1 billion in one-time revenues may be plausible given the massive expansion of gaming that Topinka proposes, Topinka provides no detail to support this assertion. More importantly, she provides no detail for recurring revenue assumptions either, and these assumptions seem to fail to take into account relatively obvious results of such an expansion. The Topinka plan would increase overall gaming positions in the state from just over 10,000 to 30,000, supposedly without expanding gaming, and assumes that this expansion will magically create more discretionary dollars to be spent on gambling, rather than competing with the current gambling that exists in the State, as well as, other businesses that rely on consumers discretionary dollars.
Inflated Revenues. When you increase the gaming opportunities in the State as much as Topinka has suggested, these opportunities begin to become counterproductive. That is, casinos are luring the same dollars statewide, and these dollars will begin to be split among facilities, rather than moved from other facilities. Some market share will be taken from Indiana and Wisconsin casinos, and as a result, we estimate based on studies by Deloitte Consulting, LLC and the Illinois Department of Revenue that about $600-700 million annually may be obtained from recurring revenues, about half the $1.25 billion annually that Topinka predicts. There is absolutely no empirical support for an additional $1.25 billion in revenue per year.
Unrealistic Assumptions. The Topinka budget also makes another misleading prediction in its four year plan. It assumes that new positions can be built immediately, and that the legal hurdles that have tied up the tenth riverboat license for years will be immediately surmounted and a new Chicago casino immediately constructed. As most of us know and as suggested in the discussion about capital above, it takes time to build additional space, we estimate very aggressively no less than 9 months for existing casinos and 18 months for the Chicago casino. This means that the full value of the gaming expansion won’t be available until 2010 or 2011- at the earliest. And this doesn’t even take into account the amount of time the 10th license will remain in limbo.
6. School Construction
Unrealistic Assumptions. As the Senator points out, debt service costs will mature at the same rate as the underlying capital spending. However, contrary to his assertions, school construction spending historically has occurred much more quickly than ordinary capital spending. This is also because Republican obstruction to a school capital bill has left our schools desperately in need of improvements, and these improvements need to begin in the next 18 months, not over a period of 5 years. Otherwise, the Topinka plan would unnecessarily delay the commencement of repairs critical to our children’s safety and ability to learn.
7. Pensions
Misleading the Taxpayer. The listed pension increase includes planned increases to POB debt service (at a rate which is consistent with the 1995 funding plan and is GRF funded), as well as increases in required contributions and includes all funds. However, Senator Rauschenberger is apparently unaware that 90% of our pension funding comes from the State’s general funds, and that over 95% of POB debt service does. A GRF value for FY08 is not $520 million, depending on employee payrolls, it will be over $600 million in FY08, and will rise similarly in FY09 and FY10. And, despite her claims, Topinka’s plan would not “fully fund†the pensions- it would only fund the pensions at the level proposed by the flawed Republican 1995 payment schedule, which underfunds the pensions each year until 2035.
8. New Hiring
Unrealistic Assumptions. The hiring of 400 correctional officers over 4 years is a departure from Topinka’s previously public support for the AFSCME proposal to increase correctional officers by 600 immediately and to increase statewide staffing (See: Chambers, Aaron “Union: Forensic shortage hinders evidence analysis†Rockford Register Star 3/28/2006). As AFSCME’s entire proposal was to increase statewide staffing by 2,000, rehiring was based on that calculation, and includes both salaries and related costs (pension, health insurance, social security, fringe benefits), raising average cost of employee to approximately $75,000 per employee (on average over four years)- the very number Topinka used in her August 17, 2006 budget cuts proposal. Her assumption that her budget can be based on a lower number is not credible in this context.
9. Pay Raises
Flip-Flop from Prior Position. “Treasurer Judy Baar Topinka, the Republican candidate for governor, got big cheers from the crowd when she said non-union workers should get the same raise as union employees. Then she tells the IAMG that merit comp employees deserve a raise†(Finke, Doug, “Statehouse Insider†Copley News Service, 5/14/2006).
10. Energy Plan
The estimate simply includes $45 annually as debt service in support of $500 million in capital spending Topinka has proposed in her energy plan, as well as $15 million in one time spending proposed in the energy plan.
11. “Porkâ€, “No-Bid Contracts†and Firing State Employees
Misleading Taxpayers. The Topinka Plan also attributes $200 million annually in savings to “reducing porkâ€, eliminating “no-bid†contracts, and getting rid of merit compensation employees. These “savings†were not included in the initial critique of the plan because they are misleading and even her plan shows that they will be unlikely to occur.
Flip-Flop: Pork- Although Topinka claims that she can save $100 million a year by eliminating “pork†from the budget, she does not state what this “pork†includes and cites only tiny examples of what she claims is $100 million a year. Instead, in her description of one-time spending, she promises to allocate funds to “pay-as-you go local projectsâ€- in other words pork. Topinka can’t both promise to pay for pork and eliminate it at the same time- that is a flip-flop.
Flip-Flop: No Bid Contracts. Although Topinka claims that the State can save $75 million a year on eliminating “no-bid†contracts, the Treasurer’s office from 1995-2006 has a significantly higher rate of issuing contracts that were not competitively bid than the Governor’s Office. If Topinka had wished to end “no-bid†contracts, she could have started with her own office, especially with contracts awarded to her campaign contributors. The contracts that Topinka would reduce also affect core state services, such as vaccines for poor children and the ability to get service for Medicaid recipients at Children’s Memorial Hospital, once again a tiny portion of her $300 million claim.
Unrealistic Assumptions. Topinka’s estimate that it can save money by firing merit compensation employees hired over the last four years shows an inability to understand the business of governing and is yet one more unrealistic assumption to base savings on. The 350 employees that Topinka would fire (and not replace any) are in many cases long-term state employees who have changed agencies, or whose term has expired and has taken a non-term position. Firing all of these employees would leave a vacuum that other employees would have to fill, not unlike the vacuum created by George Ryan’s $3.5 billion ERI mistake of 2003.
12. Economic Development Plan
Unrealistic Assumptions. Topinka’s Economic Development Plan makes unrealistic assumptions, and like most other giveaways to large corporations, will actually cost the Illinois taxpayer money. There are already plentiful tax credits that provides hundreds of millions of subsidies to these industries. Though Topinka seems lately to intend for this plan to apply only to incremental manufacturing jobs (or in the case of the new jobs credit, all jobs), in any given year the average job growth is made up of a lot of new jobs and job losses. Unfortunately, Topinka’s plan would provide credits to the new jobs (and make these credits transferable, so even large corporations who outsourced jobs to India could take advantage of them), but not provide a counter measure to offset the lost jobs. This doesn’t make sense, and is estimated, depending on how the plan is structured (whether or not retaining current manufacturing jobs) to cost between an incremental $90-450 million per year, growing each of Topinka’s four years.
13. Elimination of Fund Transfers and Chargebacks
Flip-Flop from Prior Position. Topinka has previously opposed the administrative chargeback procedure and blocked it for over a year (See: Sweeny, Chuck “Topinka blames gov for ‘dysfunctional’ state†Rockford Register Star, 4/21/2006), but now Topinka has flip-flopped and appears to support it, though she has publicly claimed to end “fund raidsâ€. The estimate provided for lost revenue in total is an average of four years of transfers from FY2004 through those anticipated in FY2007. After opposing this practice for four years, we welcome her support if she currently supports processing administrative chargebacks to special funds.
Misleading the Taxpayers. However, Topinka’s opposition to fund transfers is also misleading. Fund transfers are approved and determined by the General Assembly, and Topinka has had and will have no ability to prevent them, short of vetoing fund transfers authorized by the legislature and creating a deficit.
We have responded to the unrealistic and misleading numbers thrown together in the Topinka proposals. However, like the public, we have little or no information. Topinka needs to answer the question – “How did you determine your revenues and budget cuts? Are they real?†Even Topinka’s spending is misleading and needs clarity, especially her education spending. Claiming it doesn’t make it true. Her budget just doesn’t add up.
I would like to thank both campaigns for putting the effort into these highly detailed pieces. This electronic budget “debate” is unprecedented in Illinois. If either side feels the need to continue this, I’m completely open to more.
- Chick McGann - Thursday, Aug 31, 06 @ 11:44 am:
Holy smokes. I took two naps and did the New York Times crossword puzzle during the time it took me to read the Filan Retort.
- William - Thursday, Aug 31, 06 @ 11:53 am:
Simplicity is truth’s most becoming garb. And I might add brevity.
I initially wasn’t real impressed with Steve (Rauschenberger)’s response, but seeing how this from Filan drones on and on and on and on …
I have to say that Steve made the better case.
Thanks, Rich.
- T.R. - Thursday, Aug 31, 06 @ 11:54 am:
Cliff notes???
- publius - Thursday, Aug 31, 06 @ 11:54 am:
let’s just look at a tiny piece of this reply—managed care for medicaid recipients—the administration has decreased the size of the managed care program signicantly and now has aprogram called pccm’s —the program is a sham—it doesnt’ provide any means for doctors to actually manage care—puts no oversight or controls on specialist referrals or hospital stays—and simply gives doctors a management fee–and though the program supposedly requires things like 24 hour availability from physicians–the department is ignoring—or”delaying” those things which might make the program have some effect—most other states have real managed care programs which mandate coverage and do—to some extent — control rising costs.
- Wumpus - Thursday, Aug 31, 06 @ 12:11 pm:
Where is the “don’t pay the bills” portion of the Gov’s plan?
Also, did Filan take another vacation day to rebut Steve’s rebuttal?
- Troy News Guy - Thursday, Aug 31, 06 @ 12:11 pm:
If he did this crap on his own time, he REALLY needs a hobby! The truth is NO ONE can tackle the public trough in Springfield (pork, nepotism, no-bid contracts, ad nauseum) until the average person (not just political junkies) gets involved, realizes the crap going on, gets fed up and registers to vote. Until then, Illinois is doomed to dorks fighting over the spigot. Get me out of here!
- Anonymous - Thursday, Aug 31, 06 @ 12:13 pm:
How did Filan do on his ethics test? He is saying NONE of this was done on state time, equipment or property? REALLY?
- Tropy News Guy - Thursday, Aug 31, 06 @ 12:21 pm:
Hey Illinois….thanks to you, our sick children are pushed to the back of the line at St. Louis hospitals. All our doctors went to Missouri, and now they can’t even get paid (more than 200 days since the last check!). I’m serious…. I gotta get out of here!
- Louis G. Atsaves - Thursday, Aug 31, 06 @ 12:26 pm:
I’m very impressed with both, although Filan tends to meander a bit. I got a little tired of the “misleading the taxpayers” or “”flip-flop” start to each section but I understand that he is being partisan at the moment as was Rauschenberger.
Both are very intelligent men with differing viewpoints. The more fiscally responsible viewpoint that gives us the biggest bang for the buck seems to be coming from the Topinka camp right now.
If you can continue to foster such debates Rich not only for Governor but other state offices even state senate and state representative, it would be GREAT!
Keep up the good work!
- Scoop - Thursday, Aug 31, 06 @ 12:29 pm:
I think a debate between these two, on this site, will trump any debate we see on TV between Topinka and Blagojevich.
Rich, will there be more “debates” like this? There should be, bravo.
- Wumpus - Thursday, Aug 31, 06 @ 1:23 pm:
If there were debates, the only viewers would be people who read this site and people who want to learn to do the Rasuchie. Fiscal debates, although critical, do not televise well.
- Bubs - Thursday, Aug 31, 06 @ 1:27 pm:
This was precisely what I thought it would be - long on tedious campaign invective and assignations, and short on details, or explanations of where he gets his numbers from.
For example, what the heck do the Blago’s campaings false allegations of “flip flopping” have to do with budget numbers?
Overall, a pretty weak, unprofessional effort from a sitting budget director. As usual, everything from the Blagovich Adminstration is on the curve. These guys couldn’t draw a straight line with a ruler.
- Rich Miller - Thursday, Aug 31, 06 @ 1:44 pm:
Actually, Bubs, I’ve read through it twice now and I think Director Filan made some very good points, most of which were based on facts rather than hyperbole. We’ll see what Rauschenberger has to say, if he chooses to respond, but I think Filan has the upper hand here.
Of course, we haven’t yet turned the two analysts loose on the governor’s proposed spending/revenue plans.
- Anon2 - Thursday, Aug 31, 06 @ 1:48 pm:
I’m shocked. Filan could not find a single thing that was not misleading, a flip-flop, or based on unrealistic assumptions. Sounds like a credible reveiw and discussion of the issues to me.
I hope the blog debate continues. Maybe Filan can be a bit more professional and articulate in the next go around.
- Sound Reasoning - Thursday, Aug 31, 06 @ 2:01 pm:
Rich, does the Governor have a plan yet? I thought he has refused to provide one until after the election.
Maybe it’s easier to pick apart another’s plan than provide any reasonable alternative.
- Rich Miller - Thursday, Aug 31, 06 @ 2:09 pm:
Actually, “Sound Reasoning” I just sent an e-mail to Rauschenberger asking if he would pick apart what we know about the governor’s plan. I’m also looking at letting the two campaign go after each other on energy and the environment.
- Yellow Dog Democrat - Thursday, Aug 31, 06 @ 2:13 pm:
I agree with Bubs. When do we get to see the numbers that purportedly back up the govenor’s lottery proposal?
- Jaded - Thursday, Aug 31, 06 @ 2:23 pm:
I have to agree with Rich, that was a pretty good response by Filan however I would like him to answer his own last question. He wrote:
“How did you determine your revenues and budget cuts? Are they real?†Even Topinka’s spending is misleading and needs clarity, especially her education spending. Claiming it doesn’t make it true. Her budget just doesn’t add up.”
That is what people have been saying about your budgets for 4 years now. Claiming it does not make it true Mr. Filan (who know like a Governor who says he has balanced the budget when there was still a $3 billion deficit). I am glad that you finally realize this fact.
- anon - Thursday, Aug 31, 06 @ 3:03 pm:
I’m sorry - if Filans mouth is moving he’s lieing.
I mean this is the same guy who said that the states budget was balanced this last year. “we took in more money that we spent” Hell, any one can say that when you only pay interest on all the money we’ve borrowed the last three years, don’t pay $2 BILLION worth of Medicaid bills, and skip a $1 BILLION pension payment.
By the way, didn’t Filan use to write for some budget association he use to belong to until he got his pink slip?
- Anonymous - Thursday, Aug 31, 06 @ 3:16 pm:
Home Run by Mr. Filan. Nicely done.
- Bubs - Thursday, Aug 31, 06 @ 3:44 pm:
Rich, he’s the budget director and he won’t tell us where his numbers are coming from, even when Rauchy challenged him on them!
I’m starting to think “FILAN” is a shorthand for “Frequently Is Loose About Numbers”, (and I certainly was temped to use a much stronger word in the middle.)
- Downstater - Thursday, Aug 31, 06 @ 3:49 pm:
Anon 3:16,
Take off those rose colored glasses. Didn’t you get the memo that Illinois is dead last in the nation in debt liability. Filan can spin all he wants, but eventually this debt that Blago and company has incurred is going to have to be paid off.
- bob white - Thursday, Aug 31, 06 @ 4:35 pm:
I disagree with those who thought Filan’s response was strong. I thought it was vague and full of political answers that are besides the point.
- Budget Watcher - Thursday, Aug 31, 06 @ 6:01 pm:
Filan’s Medicaid “facts” are far from factual. There was no approved hospital assessment that generated over $600 million. Hospitals did not receive almost $500 million, there is no Developmenal Disabled assessment program worth $40 million, and GRF not not get $80 million. Liar is a pretty strong term, but he’s awfully close on these items.
He also refuses to understand the reason for federal block grant funding, which is to replace the funding schemes that he claims will be lost under Topinka’s plan. Sometimes I think he’s purposely dense.
- a friend - Thursday, Aug 31, 06 @ 8:40 pm:
budget watcher…
…you may need some new glasses. why don’t you ask the illinois hospital assn about the 500 mil they’re set to lose under topinka’s plan, or ask sen. schoenburg (who sponsored the hospital assessment bill) about the 80 mil the state stands to lose — don’t take filan’s word for it. get your facts straight for once, please.
also, not a single state in the nation uses a block grant to fund their mediciad programs. I hardly think that 49 other states could all be so wrong…
- Little Egypt - Thursday, Aug 31, 06 @ 8:57 pm:
It was my pleasure to scroll past Filan’s crap and read just the bloggers. I agree though that this all could not have been done on his own personal time with his own personal computer.
- Shallow Pharnyx - Thursday, Aug 31, 06 @ 9:01 pm:
Rich,
You do realize that Filan had GOMB doing his numbers research?? Who did Rauschenbergers?
- Anonymous - Thursday, Aug 31, 06 @ 9:02 pm:
No flip-flop by Topinka?! Good Lord. As Filan points out, Topinka wants to nearly triple the number of gaming positions, and build the biggest casino yet in Chicago. In the primary she specifically said she was against an expansion of gambling.
Anyone still saying that’s not a flip-flop isn’t sane.
- So Blue Democrat - Thursday, Aug 31, 06 @ 9:06 pm:
Do you really think Filan wrote this response? No, it was probably want of his young workers in GOMB. If he really wrote it, I think he has too much time on his hands. He needs to worry about the crisis in state government.
- zatoichi - Thursday, Aug 31, 06 @ 9:42 pm:
Where in Filan’s response does he discuss how the State’s debt will be paid? He goes on about flip flops and faulty assumptions. This would have been a great place to describe how the State will move to 45th place on the national economic ladder.
- Budget Watcher - Thursday, Aug 31, 06 @ 10:41 pm:
To A friend,
You can’t lose what you never had - there was no assessment for hospitals. None. Wasn’t approved by the feds in FY2006. No $500 million to hospitals, no $80 million to GRF, no $40 million to DD facilities, and no $60 million to nursing homes. Schoenberg sponsored the state bill authorizing the HFS to pursue an assessment, but the feds never approved it.
The second point, and I’m typing slow so you can understand, is that a federal block grant would compensate for the foregone funding schemes like assessment taxes and intergovernmental agreements with Cook County and the University of Illinois.
- Budget Watcher - Thursday, Aug 31, 06 @ 10:51 pm:
One last point to a friend. The Comptroller’s website can tell you whether hospitals got their money. The fund number is 346, the agency code 478, the division code 65 - submit the query and tell me why there’s $1.218 billion in unexpended appropriations for FY06. The answer is because the assessment didn’t happen. Check your own facts next time.
- a friend - Thursday, Aug 31, 06 @ 11:50 pm:
budget watcher…
the assessment didn’t happen? that’s funny considering that every major media outlet reported on the fact that the feds appproved the assessment, not to mention the fact that the hospitals paid the tax needed to generate proceeds off the assessment and then they and the state received the very federal funds that you claim don’t exist. I wonder what that extra 80 million supplemental bill passed by the general assembly was for? you obviously have no idea what you are talking about.
- a friend - Friday, Sep 1, 06 @ 12:06 am:
budget watcher…
just one more note if you will about block grants. perhaps you didn’t take the time to read my previous comments, so i’ll return the favor and write slowly here for you as well…not a single state in the nation has adopted a block grant program for medicaid. perhaps you know something that all other 49 governors and general assemblies don’t? perhaps you need to spread the block grant gospel to a wider audience because no one seems to hae gotten your memo. call me crazy, but I think you and topinka are in the minority here.
- Budget Watcher - Friday, Sep 1, 06 @ 12:23 am:
A friend,
Assessments happened in FY05 but not in FY 06. It was a one year deal. One of us knows the facts. Again, if you don’t believe me, call HFS tomorrow.
Also, block grant funding will obviously require a federal waiver. Illinois, more than any other state in the union, relies on funding schemes like assessments and intergorvernmental agreements. This makes Illinois reliant upon an inefficiency fee-for-service healthcare delivery model. The General Assembly commissioned a report two years ago by the Lewin Group that backs this up. Block grant funding circumvents this reliance upon funding schemes and would allow HMOs to manage care. The Illinois Hospital Association will hate the idea, so expect them to be critical.
- Shallow Pharnyx - Friday, Sep 1, 06 @ 7:56 am:
Rich,
Will you be leaving this up over the holiday weekend? Please do.
- Shallow Pharnyx - Friday, Sep 1, 06 @ 8:14 am:
A friend? A friend of whom?- Blago? “also, not a single state in the nation uses a block grant to fund their mediciad programs. I hardly think that 49 other states could all be so wrong…” We LIKE being in last place. 49 other states can’t keep up with our lack of pension funding.
- Raoul Descender - Friday, Sep 1, 06 @ 9:15 am:
Why do we need to have a shaman tell the tale of the numbers? Instead, the state and Mr. Filan’s department especially, should produce financial statements and financial projections that are comprehensive and comprehensible. The complexity and tardiness of the state’s financial reports obscure the state’s real fiscal condition, a tactic that should be a outlawed.
- a friend - Friday, Sep 1, 06 @ 4:28 pm:
budget watcher…
i’ll go at this with you one more time.
obviously I’m talking about 05 since everyone knows the the feds are still reviewing the 06 assessment. from reading the response prepared by filan, he seems to acknolwedge that as well. with hastert and the illinois hospital assn gunning for this, illinois is well positioned to get this approved for 06 (and remember, the hospital assessment is a five year arrangement, but still needs fed approval each of those years). as for block grants, the fee for service system you criticize allows the state to capture far more federal match than a block grant ever would. since the state is entitled to reimburse providers for any and all medicaid services, should the block grant run out we taxpayers are stuck paying the difference. so that means we either cut money from other programs, raise taxes, reduce rates to providers or throw people off healthcare. I don’t think most people are ok with any of these sceanrios. as costs for heathcare increase (prescription drugs, medicial services, admin, etc), the fee for service model guarantees that the state receive at least 50 percent back on every dollar they spend. a block grant has zero flexibility for this and states are stuck with whatever congress decides to give us. again, block grants are bad for states and that’s why not a one has adopted them.
shallow pharnyx…
shame on me for saying anything that might remotely seem supportive of this administration. I’m sure you have no biases, of course. with that said, yes, illinois does have the worst funded pensions, but that’s been the case for several years and you may not like accepting the facts (since you seem far more comfortable with empty rhetoric), but it was the republicans and that created this mess over the last 20 years or so. and, the pensions were worse off, dare I day it, before blago. you may not like to hear that, but the truth is often hard to take.