* From a press release…
Illinois Comptroller Judy Baar Topinka on Thursday said she supports a proposed cigarette tax increase for Medicaid provided that it is tied to significant spending cuts and approval of a gaming expansion bill that includes a Chicago casino and slot machines at horse racing tracks.
The proposal offered by the state fiscal officer represents a compromise in the ongoing state budget and Medicaid negotiations.
“I am not inclined to support any tax or fee increases, but can back the cigarette tax provided that critical spending cuts are made and much-needed support of the horse racing industry is passed,” Topinka said. “Our biggest problem in this state is spending, and that has to be addressed. But the reality is that increased revenue also has to be a part of balancing the budget, and this compromise accomplishes that as well.”
The Governor and members of the General Assembly have been at odds over the proposed tax and gaming expansion. Republican legislators have opposed the cigarette tax, saying the state should focus solely on spending. At the same time, Gov. Pat Quinn has said he will not support gaming expansion legislation.
But given an estimated state bill backlog of $8.5 billion and the urgent need to pass Medicaid reform legislation, Topinka emphasized the importance of finding common ground.
“This is a common sense fiscal solution,” Topinka said. “And most importantly, it will provide important spending cuts and revenue enhancements to help put the state back on track to fiscal stability.”
That statement makes her the first Republican to back the tax hike. But she may not end up being the only one. From the Tribune editorial page…
On Medicaid, lawmakers sound like they’re close to a $2.7 billion deal to resuscitate the ailing health care program for the poor. The cornerstone: $1.4 billion to $1.6 billion in cuts, including limits on prescription drugs and certain surgeries. The deal being discussed late Thursday would be relatively good news for hospitals and nursing homes: A proposed 8 percent rate cut has been whittled to 3 percent — $240 million — with protections for safety-net hospitals that treat a disproportionate share of Medicaid patients and for critical-access hospitals that serve large rural areas.
Republicans are signaling that they can live with a $1-a-pack cigarette tax as part of a deal that includes significant spending cuts. That would raise about $700 million, leveraging federal funds. It’s a reasonable way to spare more Medicaid cuts, and higher cigarette prices would encourage thousands of people to quit or never start smoking.
Also in the mix is a state waiver that could add 100,000 patients to Cook County’s Medicaid rolls. This provision would mean a windfall of federal reimbursements for the county’s cash-strapped health care system, but it wouldn’t cost the state a penny it isn’t already paying to care for those patients. It’s win-win.
All of this is in flux, but the lawmakers we’ve talked to hope that the Medicaid reform bills will be filed in the Illinois House on Monday and come to a vote as early as Tuesday. That’s an ambitious schedule for a Legislature content to kick this reform down the road too many times in the past.