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* If you were watching yesterday’s live session coverage, you already know that large blocs of the Medicaid restructuring package were either passed or advanced yesterday. By far, the best story about yesterday’s action in any newspaper was written by Doug Finke. Some excerpts…
The House voted 94-22 and the Senate voted 44-13 to adopt the cuts in Senate Bill 2840, which range from outright elimination of some programs – like Illinois Cares Rx, a prescription drug assistance program for seniors – to taking extra steps to ensure that those receiving aid are entitled to it. The bill now heads to Quinn’s desk. […]
Also as part of the package, the House and Senate sent Quinn a bill that would allow Cook County to enroll more people in the Medicaid program using local and federal funds, but not state funds. The vote in the House on House Bill 5007 was 62-55 and 35-22 in the Senate. […]
In an attempt to appease Republicans, who came under fire from right-wing groups for considering something that helps implement Obamacare, Democrats offered another bill, Senate Bill 3397, that would restrict the number of unpaid Medicaid bills that the state can carry over from year to year. The state would be be allowed to carry over only $700 million to fiscal year 2013 and $100 million to fiscal year 2014. […]
Those three bills are linked — if one of them fails to pass or isn’t signed by the governor, the others also will fail.
“The governor likes the cigarette tax,” Cross said. “The governor does not like what we call section 25, which prevents him from putting bills off. That’s why you’re seeing some of those connections.”
Another piece of the package will combine a $1-per-pack cigarette tax increase and property and sales tax exemptions for hospitals, according to Danny Chun, spokesman for the Illinois Hospital Association. The bill number for this portion is expected to be Senate Bill 2194, but the language has not yet been filed.
Cross said he expects some Republican House members to vote for the cigarette tax increase. Most believe every bill in the package will have to collect support from both Republicans and Democrats, because the solutions are so unpalatable.
* While Leader Cross is agreeable to the cigarette tax hike, the Senate Republicans are still standing firm against it…
Sen. Dale Righter, a leader on Medicaid issues for Senate Republicans, said he doubted any of his GOP colleagues would support the tax increase. If the tax doesn’t pass, Democrats would be forced to return to the bargaining table to consider more spending cuts, he said.
The Senate Democrats have twice passed a cigarette tax hike without Republican votes, so they’re probably not needed this time, either.
* Ashley Griffin and Jamey Dunn over at Illinois Issues get down in the weeds…
Some of the most controversial cuts in the plan are the eliminations of maintenance dental care for adults and Illinois Care Rx, which is a prescription drug program that helps low-income seniors pay for their medicine. Approximately 180,000 seniors would be affected by the loss of the Illinois Care Rx program. The cut to adult dental care would affect 172,000 Illinoisans. “We believe that these cuts in human terms are very damaging. People will not get less sick because we made these cuts,” said William McNary, co-director of Citizen Action/Illinois. According to McNary, the cut to the Illinois Rx program is the biggest reduction in the plan, and it will cost the state more in the long run if seniors are not able to get the prescription drugs they need and end up in nursing homes.
Under the reductions, adults who have oral infections could get a tooth pulled. But Dave March, director of government relations for the Illinois State Dental Society, said most oral surgeons, who would perform an extraction in an emergency situation, do not take Medicaid. He said patients with oral infections often end up in emergency rooms, which have little to offer them. “All they can do is give them antibiotics and send them away.” He said that such infections left untreated can turn into life-threatening abscesses.
Those who opposed SB 2840 argued there are other options legislators could have considered, such as fund sweeps, applying sales tax to services and closing some of the corporate loopholes to help the state bring in more revenue instead of cutting Medicaid. “There’s lots of things, ladies and gentlemen, we can do rather than putting senior citizens and disabled people out on the street without having access to their health care,” Chicago Democratic Rep. Mary Flowers said during floor debate.
Members of the Black Caucus and the Latino Caucus came out strongly against the bill in both legislative chambers. “Once we push that green light, are we pushing people into the grave? That’s the question that we really need to ask ourselves,” said Sen. James Meeks, a Democrat from Chicago.
Proponents acknowledged the pain that the plan would cause but said the changes are needed to keep the system from collapsing because the state cannot afford to reimburse providers. “There are going to be people who get benefits today under the Illinois Medicaid program … who will no longer receive them. Or they’re not going to receive them in as convenient of manner as they do today, and that’s going to be tough on some people,” said Sen. Dale Righter, who served on the legislative working group that negotiated Medicaid reform.
“This is not immoral,” said Sen. Matt Murphy, a Palatine Republican. “What would be immoral in my mind would be to sit back, pretend there’s no problem” and let the system fall apart.
* Dave McKinney writes about something we pointed out yesterday…
Included in those cuts is a provision affecting 536 children with “medically fragile” conditions who live at home on ventilators or who require around-the-clock nursing care, like Letty Young. For the first time, their families would be asked to share more in the state’s costs for their children’s highly specialized services, saving the state $15 million.
Hamos told reporters that families in the agency’s Medically Fragile/Technology Dependent program will have to begin paying $400 a month co-payments, on average.
“We thought it was fair, in the world we live in, that there be some co-payments,” Hamos told a House panel Thursday.
But Myra Young, Letty’s mother, said that isn’t something her family can afford and may necessitate moving her daughter, who was born with congenital fiber-type disproportion, permanently from their two-bedroom condo at North and Clark into a hospital under a different Medicaid program that would ultimately wind up being more costly to the state.
“My daughter was in the hospital for her first nine months. She was diagnosed at about 2œ months old. She couldn’t breathe on her own. She had no muscle tone. She struggled to keep her eyelids open. She had no movement,” Young said.
“The cost-sharing is not really an option. We can’t afford it,” Young said. “There’s no way for families — my family — to be able to do this. The costs are so exorbitant. How they think that’s the place to make the big cuts is just unbelievable.
“This isn’t the life we expected,” she continued. “I think a lot of people don’t realize this could be them. This is a spontaneous, genetic thing. It could be anyone. People need to get behind us. This could be their loved ones.”
* Related…
* Illinois Legislature passes $1.6 billion in Medicaid cuts
* Illinois House passes bill to cut $1.6 billion from Medicaid
* Illinois Legislature approves $1.6B in Medicaid cuts
* Illinois House, Senate OK big Medicaid cuts
* Legislature OKs Medicaid cuts; no vote yet on cigarette tax
* Cuts to Medicaid program headed to the governor
* Major Medicaid Reform Approved, Gov. Will Sign
* Senate, House Black Caucus members express concern with potential Medicaid cuts
* Medicaid cuts come with catch
* Quinn, seniors butt heads on Illinois Cares Rx
* Cook County could get Medicaid reprieve
* Illinois residents react to vote on Medicaid
* Despite Emergency Funding, State Child Care Money Still In Jeopardy
* Choslovsky: Who speaks for the disabled?
posted by Rich Miller
Friday, May 25, 12 @ 10:05 am
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Well, on the dental issue: you don’t have to go to an oral surgeon to get a tooth pulled, ya know. Dentists pull infected/abcessed teeth daily @ fairly low cost. Dentists who take Medicaid, as well. So I don’t get the fuss about that.
Comment by Mary Friday, May 25, 12 @ 10:26 am
–“This is not immoral,” said Sen. Matt Murphy, a Palatine Republican. “What would be immoral in my mind would be to sit back, pretend there’s no problem” and let the system fall apart. –
What’s the morality of making these painful cuts to the old, sick and disabled, but not having the guts to charge me another buck for a pack of smokes to help keep the system from falling apart?
Are those Tea Partiers that scary?
Comment by wordslinger Friday, May 25, 12 @ 10:35 am
==“This is not immoral,” said Sen. Matt Murphy, a Palatine Republican. “What would be immoral in my mind would be to sit back, pretend there’s no problem” and let the system fall apart.==
Of course, one could raise taxes to pay for the program. How does one weigh the morality of health care for the poor vs taxes?
Comment by Pot calling kettle Friday, May 25, 12 @ 10:36 am
I support the concept of a nominal tax on financial transactions, like the one nurses rallied for in Chicago last Friday. I understand that Medicaid needs to be saved, but the cuts are still sad.
Though I haven’t studied the issue, a tax equivalent to fifty cents on every $100 in financial transactions seems quite reasonable, and it’s a way to help the elderly and sick who can’t afford their medical treatment.
Comment by Grandson of Man Friday, May 25, 12 @ 10:47 am
You guys, it’s taxes that are immoral. Didn’t you know taxes have only hindered human spirit and opportunity throughout history. Whether it’s economic development from railroads and the interstate highway system to crime prevention to caring for the most vulnerable in our society, taxes have prevented humans from accomplishing anything of substance or value. So, if we cut all our programs and all the taxes we’ll flourish like never before!
Comment by Aaron Friday, May 25, 12 @ 10:52 am
Thanks for printing that email yesterday on the MF/TD issue.
You probably get a ton of those every day, but I’m glad you included it and the attachment. Learned a lot.
Comment by Freeman Friday, May 25, 12 @ 11:08 am
So we charge another buck a pack for cigs. Didn’t I read somewhere that the poor are the biggest consumers of this product. If most of the people smoking are getting some sort of public assistance what does this tax accomplish?
Comment by Nieva Friday, May 25, 12 @ 11:16 am
If one looks at the entire bill, it should be noted that the hospitals are going to be required to treat people at no cost, who otherwise were covered. Looks like health insurance costs will rise to cover what use to be a government expenses.
Comment by DaRealStory Friday, May 25, 12 @ 11:24 am
On the MF/TD program savings, if you have 536 families that will be asked to pay an average of $400 per month copay, that comes out to $2,572,800, (ignoring for the moment the reality that many wont be able to pay and any savings will be eaten up by transfer of some of these kids to a higher level of care). So where does the claimed $15,000,000 savings come from?
Comment by Downstate weed chewing hick Friday, May 25, 12 @ 11:25 am
According to the Governor’s Accountability Portal, the DCEO has YTD disbursements of $722 million. Under the banner of “Awards and Grants,” you can find $684 million of cash shoveled out the door to local governments, non-profits ($274 million), construction grants ($161 million)
Yet the mantra is that “there is no place to cut.”
That’s nonsense. Museums that can’t survive without taxpayer support won’t be missed. Cities and towns can do without their grants, particularly if they cut pay and benefits.
The fact is that Illinois and its local governments have gone on a decades long spending binge.
Now that;
a) the money has dried up and economic activity has slowed
b) public employees threaten to sue if their benefits are cut, and
c) the tax well is running dry (for political and/or economic reasons)…
We are cutting medical access to the poor and needy so that flush trough-feeders at needless entities like the;
Capital Development Board
DCEO
Non-profits
Connected construction projects
Local governments
all can keep their gravy train rolling.
As a pretty conservative guy who almost always votes Republican, I don’t feel even slightly responsible for the horrors being visited on the poor people suffering the cuts.
It’s not that I don’t care about them. I think its horrible.
It’s that the political class always hurts the most needy while squealing like stuck pigs if you go after the absurd numbers of useless government entities, the bloated administration jobs, the bloated salaries they pay themselves, the greedy bond dealers and their purchased, debt-churning local boards of ‘trustees,’ and of course, the fat pensions that can’t be touched.
The poor aren’t suffering because the evil tea party won’t pay an extra dollar for cigarettes.
The poor are suffering because billions of dollars of taxpayer money is being spent on things that could be cut to the bone, but won’t because of greed and political clout.
Comment by Bruno Behrend Friday, May 25, 12 @ 2:04 pm
===the DCEO has YTD disbursements of $722 million===
DCEO is basically a federal pass-through. Check on that first. Then come back.
Comment by Rich Miller Friday, May 25, 12 @ 2:17 pm
DaReal Story -
Currently, hospitals actually collect less than 15 cents on the dollar for person who are under 200% of the poverty level. And for most hospitals, they account for less than 2% of their patients. So reducing the collections from 15 cents to 0 cents, for less than 2% of the patients, is not going to create a lot more cost shifting.
Comment by Anonymous Friday, May 25, 12 @ 2:28 pm
So ask the Feds to “pass through” to something other than some of the unneeded grant recipients.
One could also take issue with “federal pass through” as a concept. Revenue sharing from Fed to State to Local is another one of those practices that should end.
I know, a trillion here and a trillion there, and sooner or later it all adds up to real money.
Regardless, I’m sure you (or others here) have an answer for all of it.
We can’t cut this because…(some one will always have an answer that indicates the world will end)
It won’t.
The fact is that we can find places to cut if we want to. We don’t want to, so we cut medical aid to the poor.
In the meantime, I’ll do some research on the DCEO and how much of it is a) federal passthrough, and what, if anything, might be able to directed to more rational allocations.
In the meantime, folks, play around with other areas of the Gov’s portal. The Board of Ed has $7 billion plus to play with, but again, I’m certain there isn’t a dime of waste there. It all goes to the children.(/snark)
http://accountability.illinois.gov/Expenditures/Agency/Categories.aspx?Year=2012&Agency=586
Comment by Bruno Behrend Friday, May 25, 12 @ 2:42 pm
@Downstate Weed Chewing Hick
In addition to the co-pay, they are counting savings by assuming some kids whose families make over the income cap will just disappear. They aren’t accounting for the costs of them being placed in hospitals or nursing homes because the cost of caring for them at home is more than their entire income.
This is a WGN story of the MFTD mom featured in the Sun Times story.
http://www.wgntv.com/videogallery/70137231/News/Illinois-medicaid-cuts-to-hit-poor-and-elderly#gl-0
What’s sad is she is one of the ones who won’t be kicked off, just made to pay 5% of her income. Others will be cut off entirely.
Comment by Sam Friday, May 25, 12 @ 2:45 pm
===So ask the Feds to “pass through” to something other than some of the unneeded grant recipients.===
You said it should be used to help the needy. Unless you have a magic wand that you can wave at DC, I’m telling you you’re wrong. Try to keep the target a bit more stable, please.
Comment by Rich Miller Friday, May 25, 12 @ 2:46 pm
–As a pretty conservative guy who almost always votes Republican, I don’t feel even slightly responsible for the horrors being visited on the poor people suffering the cuts.–
That’s swell. Because as we all know, “community” is just another way of saying “communist,” and “social contract” is just a euphemism for “socialism.”
Any good Tea Partier recommended-reading on how these kids on ventilators can pull themselves up by their bootstraps?
Comment by wordslinger Friday, May 25, 12 @ 2:51 pm
@wordslinger What is so strange is that protection of children with disabilities is usually supported by both parties. Progressives care about those who are vulnerable. Conservatives care about the value of those with Disabilities from a pro-life view. Reagan started these waiver programs. George Bush Sr. passed the American with Disabilities Act. Lately, Palin and Santorum had a lot of appeal to the GOP base because of their children.
But among our elected officials, it seems there is a bipartisan consensus that families like the ones in that WGN video I linked are freeloaders. It’s a groupthink that is so divorced from reality, it is really striking.
Comment by Sam Friday, May 25, 12 @ 3:12 pm
Word,
You can’t fund a child on a ventilator when you are funding a bloated public employment administrative bureaucracy.
The idea that there aren’t places to cut is risible.
Comment by Bruno Behrend Friday, May 25, 12 @ 3:27 pm
Bruno:
Perhaps you should just stop before you continue to make a fool of yourself. It’s obvious you have no concept of how the state budget works or what cuts are relevant or not relevant. How about you give us an idea of exactly which bloated public employment administrative bureucracy you would cut. Numbers please smarty pants. Yes, there are cuts to be made. But your off the wall comments aren’t coming anywhere close to hitting the wall the target is on, let alone the target itself.
Comment by Demoralized Friday, May 25, 12 @ 3:55 pm
–You can’t fund a child on a ventilator when you are funding a bloated public employment administrative bureaucracy.
The idea that there aren’t places to cut is risible.–
Bruno, anytime you want to get risible and put away the moronic talking points and put a sharp pencil to numbers on paper, go ahead.
Watch out for those zeroes on the right hand side. They’re the troublemakers.
Taxes have been raised. Horrible cuts are being made.
Still, I hope you stroll a couple blocks on Monday and join the rest of us victims of American society for the River Forest Memorial Day Parade on Lake Street.
Even in hard times, those who gave the last measure of devotion deserve their day in our community.
Plus, that Proviso East marching band rocks.
Comment by wordslinger Friday, May 25, 12 @ 4:01 pm
So, under Bruno’s logic, we should ax the agency that is responsible for promoting Illinois as a business destination and connecting businesses and workers in Illinois to eligible training programs, grant monies, etc. Okay Bruno, make up the lost tax revenue from the work DCEO does? Are you and your GOP buddies just gonna raise the rates on everyone left, jobless and not?
Comment by Aaron Friday, May 25, 12 @ 4:19 pm
I don’t want to speak for Bruno, but one of the places he has traditionally argued spending could be reduced is in public school administration–numbers of people, salary levels (and therefore pension costs), number of districts, etc.
I suspect he is right, and I’m sure there are other places still rather than health care for the poor.
But Bruno, I will continue to argue with you that there isn’t enough of that, not even close. We needed the tax increase, it can’t be allowed to go away, and we still need to make cuts, and they are going to be painful to someone. Reduce the number of school administrators by 25%, reduce the salaries of the remainder by 25%, and that will be painful to them and their families. And then we would still need to make very large cuts.
Bruno, you say you are a Republican, and I say I am too. Where are our guys with legislative solutions for people to vote on? I thought the Senate Rs came up with some very good ideas last year, and yet not one of them made it into bill form. I believe Cullerton said he would give them a vote on their proposals.
Or, if they don’t want to offer bills they fear won’t pass, why aren’t they offering votes for some of the less harmful stuff the Ds want in return for budget concessions we Rs want? Cross seems to be doing some of that now. How about a few votes for the tobacco tax increase in return for restoring some Medicaid money for those medically fragile kids and cutting the budget somewhere else by another $200M or so?
Comment by steve schnorf Friday, May 25, 12 @ 11:25 pm