* Click here for the very good KFF tracker. Capitol News Illinois…

Illinois lawmakers have one week to pass a new state budget with little room for new spending and Congress presenting further challenges and uncertainty.

Revenue projections had already been declining as the spring session has progressed. Now, lawmakers who have long feared further federal cuts, are grappling with the U.S House’s passage of a spending plan that Illinois’ Senate president warns would be “catastrophic for working families” – as well as state finances.

“There’s no state in the union that could survive the sorts of cuts they’re proposing to health care for working families,” Senate President Don Harmon, D-Oak Park, told Capitol News Illinois about the bill that still needs U.S. Senate approval. […]

In fiscal year 2024, according to the Department of Healthcare and Family Services, the state received approximately $20 billion in federal matching funds for Medicaid. That represented about 62% of the program’s total cost.

But the legislation that passed the U.S. House Thursday morning would make substantial changes to the program that would both reduce the number of people covered by Medicaid and the amount of federal matching funds the state receives.

One of the most significant provisions that would affect Illinois, according to a summary by the nonprofit health policy research organization KFF, would reduce the federal match rate paid for people enrolled through the Affordable Care Act expansion group by 10 percentage points.[…]

In Illinois, more than 772,000 people are enrolled in Medicaid under that program and the federal government pays 90% of the cost of their care, according to IDHFS. But the House legislation would drop that matching rate to 80% for Illinois and other states that also provide health coverage or financial assistance to people who are not lawfully present in the United States.

IDHFS has estimated that provision would cost Illinois approximately $815 million in federal matching funds per year because the state currently operates two such programs – one for adults ages 42-64, and another for seniors over age 65 – although Pritzker has proposed eliminating the one for adults under age 65.

Under current state law, however, coverage under the ACA expansion program automatically ends if the federal government ever lowers its reimbursement rate below 90%.

Other provisions of the congressional bill would require states to impose work requirements on enrollees in the ACA expansion group and require those individuals to verify their eligibility for the program at least twice per year.

“We don’t have the resources to backfill that,” Moeller said. “It would be beyond the scope of our budget right now to be able to do that.”

The total impact the proposed legislation would have on Illinois remains unclear, and the bill still must be considered by the U.S. Senate, which could make changes of its own.

Illinois would also have to spend more on the Supplemental Nutrition Assistance Program, or SNAP, beginning in 2028. The bill would require states to pay for 5% of benefits and 75% of administrative costs, rather than 50% of administrative costs and nothing for benefits.

Other parts of the plan would slash federal tax incentives for clean energy and nuclear projects by the end of 2028, potentially forcing the state to pay more to reach its goal of carbon-free electricity by 2045. […]

But Rep. Ryan Spain, R-Peoria, said there might not be any reason to have a special session to adjust the budget later this year after reviewing what the U.S. House passed.

“I think that’s pretty silly, considering nothing will be effective immediately. We’ll have a lot of time to adjust,” Spain said.

Some will take effect immediately, including the de-funding of Planned Parenthood and and discontinuing Medicaid coverage for gender affirming care.

But, things can change now that the bill is in the Senate.

Capitol News Illinois is a nonprofit, nonpartisan news service that distributes state government coverage to hundreds of news outlets statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation.

This article first appeared on Capitol News Illinois and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

* Click here for the final House “manager’s amendment.” More about the clean energy aspect…

Republicans also tightened the timeline on the termination of clean energy tax credits enacted under President Joe Biden. Hardliners focused on reducing the deficit had demanded a quicker phase-out for the credits.

The new language would accelerate phase-outs for clean energy investment tax credits to 2028, up from 2031, with special carve-outs for nuclear facilities. Companies that break ground on new [solar, wind, etc.] facilities 60 days after the bill is enacted, if passed, will not qualify for the tax credits. The same applies to any facility placed into service after 2028.

That’s gonna sting if it survives the Senate.

* Related…

* Sun-Times | How Medicaid cuts from Congress could affect every Cook County resident: Still, there are some clues for how much is at stake. For example, the House bill requires that, with some exceptions, Medicaid enrollees work (research shows most already do). The county says work requirements could lead to a $88 million annual loss. That’s based on state estimates and what happened in Arkansas, when around 18,000 people lost coverage either because they didn’t have a job or because of the confusing process to keep their insurance, according to KFF, a non-partisan health policy research organization. The federal government also would reduce from 90% to 80% how much they share the cost of adults who joined Medicaid when the program expanded under the Affordable Care Act to states like Illinois that fund health care for undocumented adults and children. If this happened, the state has a law that would end the expansion program and estimates at least 700,000 people would lose insurance. The projected impact to Cook County Health: around $200 million a year. All of these losses could translate into an increase in charity care, or discounted care, for county patients if they can’t afford to pay their medical bills. In 2023, this totaled nearly $140 million at the county’s flagship John H. Stroger Jr. Hospital on the Near West Side alone, almost six times more than the next closest hospital, according to a WBEZ analysis of the most recent Illinois public health data.