* Republicans so far are saying three things about reforming the Medicaid program…

1) Providers shouldn’t be hit with a reimbursement rate cut

2) A cigarette tax hike is a non-starter

3) More efficiencies need to be found in Medicaid itself and more benefits need to be cut from more people

* But surprisingly enough, the Chicago Tribune is mostly on board with Gov. Pat Quinn’s plan…

The bottom line here is that Quinn has given lawmakers a template to do what he repeatedly has told them needs to be done. He’s given them plenty of time to debate this, to adjust, to add their own proposals before this legislative session’s scheduled conclusion May 31. All good.

The rendezvous with reality starts now. The Legislature is notorious for pushing off tough decisions to another day, another year, another decade. That can’t happen this time. “If we don’t make those changes, we won’t have a system at all,” Quinn said Thursday. He’s right.

So let’s get to it. Lawmakers, if you don’t like the governor’s solutions, let’s hear yours. Only one thing can’t change: The number is $2.7 billion.

And so is the Civic Federation…

“We commend Gov. Quinn for stepping forward in a timely fashion with a plan to save the Medicaid program — a plan that is reasonable, given the magnitude of the crisis,” says federation President Laurence Msall in an email. “We call on the General Assembly to adopt this plan or identify other comparable combinations of program cuts that are reasonable.”

* Quinn has said that anything short of that $2.7 billion goal will have to come out of other state programs. And since legislators have already cut Quinn’s proposed budget spending by $700 million, that means they’ll have to find more than $1.1 billion in cuts to Quinn’s introduced budget if they abandon the cigarette tax idea and don’t make up for the lost cash, for instance (the cig tax would raise about $336 million, which is doubled by the federal Medicaid match, so state spending would have to be cut by a like amount to make up for that approximately $700 million from the cig tax hike). No provider cuts means either $700 million in additional Medicaid service cuts or another $350 million in state budget cuts. The Republicans, however, are calling Quinn’s bluff…

But leading Republicans on the issue — Rep. Patti Bellock, R-Hinsdale, and Sen. Dale Righter, R-Mattoon — said they don’t believe Quinn will follow through on his threat of massive cuts.

* Polls consistently show that tax hikes on cigarettes are popular with a strong majority of Illinoisans. But the Republicans say they want Medicaid expenditure cuts instead…

The top Republicans in the Illinois Legislature say they won’t go along with Gov. Pat Quinn’s call for higher cigarette taxes to help the state’s struggling Medicaid program.

House Minority Leader Tom Cross and Senate Minority Leader Christine Radogno oppose “any tax increase to solve our Medicaid crisis.”

They noted that the Democratic governor said in his budget address that the state needs to reduce Medicaid expenditures and didn’t mention a tax increase. Cross and Radogno said they’ll hold Quinn to his word.

The Repubs don’t want cuts to providers, so they want the greatest pain to fall mainly on current recipients. That’s a political non-starter because there’s no way that Democratic lawmakers can agree to it. And the House Democrats clearly want a bipartisan proposal, so the cig tax hike might very well be dead if the Republican remain opposed…

House Speaker Michael Madigan, D-Chicago, will keep working with the governor, but finding a solution will require a “bipartisan coalition to get it all done,” said Steve Brown, the speaker’s spokesman.

Asked about the cigarette tax increase, Brown said, “I think anybody would say that you’re going to need a lot of other pieces of the puzzle to come together before you find a coalition to pass a revenue increase.”

* But Rep. Bellock is optimistic that a tax-free solution can be found…

Republicans on the working group said more cuts should be made.

Rep. Patricia Bellock, R-Hinsdale, said a number of cost-savings reforms passed by lawmakers last year still haven’t been implemented.

“We feel if we can get all of these reforms done and continue on a few major ones, we can get to $2.7 billion without increasing a tax on anybody,” Bellock said. “If we have a couple of more weeks to work on this, we think we can get to the $2.7 billion.”

* Courtesy of BlueRoomStream.com, here’s Gov. Pat Quinn’s full press conference on Medicaid…

* And here’s the Republican press conference on Medicaid…