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* UPDATED x1 * Obamacare implementation passes House with all Republicans opposed

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* The federal government will pick up 100 percent of this program for the first three years and then 90 percent after that…

After nearly three hours of debate, the House approved a key part of President Barack Obama’s health care law. The proposed Medicaid expansion would cover low-income adults who don’t have children at home, and up to 500,000 uninsured Illinoisans would be newly eligible for coverage. Under the multifaceted measure, 342,000 people are expected to enroll by 2017.

“This is the cornerstone of our president’s agenda. Many of us have been waiting for this moment,” said Rep. Sara Feigenholtz, a Chicago Democrat and bill sponsor. She tamped down questions from Republicans over timing by saying those who need care can’t wait another day.

The Republicans have been arguing for delay for a very long time. Last year, House GOP Leader Tom Cross urged the House to wait until after the presidential election, to see if Obamacare would survive. Obama won, but yesterday they came up with more reasons, including waiting until after the debt ceiling talks in September - as if Obama would negotiate away his signature achievement.

* More…

House Majority Leader Barbara Flynn Currie (D-Chicago), who voted for the plan, said it would result in a financial windfall for Illinois because of an influx of $5.7 billion in federally-reimbursed Medicaid expenditures in Illinois, including for 48,000 veterans who would be newly covered under Monday’s expansion.

“The real point of this bill isn’t dollars and cents, although we make out like bandits if we pass Senate Bill 26,” Currie said. “The real point of Senate Bill 26 is to make for healthier Illinoisans.”

More…

Sponsoring Rep. Sara Feigenholtz, D-Chicago, argued the plan would allow 342,000 poor adults to be eligible for the state-federal Medicaid health care plan who have long been denied coverage because they had no children.

* SB 26 passed with 63 votes with no House Republicans voting for it…

Monday’s roll call included seven Democratic “no” votes. They included Reps. Jack Franks (D-Marengo), Stephanie Kifowit (D-Aurora) Martin Moylan (D-Des Plaines), Natalie Manley (D-Joliet), Sam Yingling (D-Round Lake Beach), Katherine Cloonen (D-Kankakee) and Sue Scherer (D-Decatur).

All targets, or, at least, people who believe they’re targets. And I cannot see how Rep. Franks thinks he can run in a Democratic statewide primary after voting against Obamacare.

*** UPDATE *** Thanks to Wordslinger for pointing out this letter to the editor from Doug Whitley, President and CEO, Illinois Chamber of Commerce, David Vite, President and CEO, Illinois Retail Merchants Association and Jerry Roper, President and CEO, Chicagoland Chamber of Commerce…

As Illinois’ Legislature heads into the final weeks of the spring session, the business community is acutely aware of the serious decisions lawmakers must make to restore security to the state’s economic future. While it may seem counterintuitive to argue in favor of expanding Illinois’ Medicaid program to serve single, childless adults at or below 138 percent of the federal poverty level, our organizations believe expansion is an important part of a very complex equation in alleviating overall costs on employers in the short and long term (”Not enough doctors in Medicaid, state director says,” ChicagoBusiness.com, April 10). That’s why we urge the General Assembly to approve Senate Bill 26.

Illinois stands to gain more than $12 billion in federal funding under the expansion over the next seven years, but not without incurring some additional costs—albeit a fraction of the funding gained.

Beginning in 2014, all employers with 50 or more employees must offer full-time employees and their dependents coverage that meets minimum criteria outlined under the federal health reform law. Failure to do so will result in a penalty if an employee obtains subsidized coverage on the insurance marketplace-exchange, but no penalty is assessed if the employee enrolls in Medicaid. According to a recent Jackson Hewitt study, without Medicaid expansion, Illinois employers would face up to $106 million more in penalties assessed annually. For employers in the nonprofit sector—many of which serve the Medicaid population and support low-wage staff—the added financial penalties could mean drastic cuts in services or even shuttered doors.

We ask lawmakers to support SB 26 to expand Medicaid in Illinois to protect employers from even higher short-term costs and employees from missed coverage opportunities, and to provide additional certainty in planning for 2014.

* Other important stuff…

* Illinois House committee approves $9B human services budget: Rep. Greg Harris is chairman of the committee. The Chicago Democrat says the state is able to use unanticipated revenues to make payments that qualify for federal matching dollars. Those federal funds will lead to an overall increase in the state’s human services budget for the fiscal year that starts July 1. Larger agencies still will face cuts of about 2.5 percent in their operations budgets.

* Recommended Illinois education budget $6.6B: Democratic Rep. Will Davis of Homewood is the chairman of the committee. He says the budget will fund schools at 89 percent of the amount recommended by a state commission. The proposed funding level averts schools from cuts in general state aid for the first time in at least four years. Davis says the funding for school transportation, early childhood education and bilingual education will remain the same as the current fiscal year.

* Tax hangup stalls bill to expand gambling: Rita said negotiations are centered around both the rates that are paid and when they will go into effect. He acknowledged that in some cases, the negotiations could lead to lower taxes for some casinos. Rita also said discussions are taking place about earmarking some of the gambling revenue for specific purposes. The expansion bill, which was previously approved by the Senate, calls for some money to be allocated to economic development programs in black and Latino areas and for specific agriculture programs like extension services and to repair the Illinois State Fairgrounds. The amounts of those various earmarks are under discussion.

* Deadline near, Illinois pension reform snarled in state politics

* UNO makes changes to win back state money, restart work on Southwest Side school

* Editorial: How to save the United Neighborhood Organization

* ADDED: UNO makes changes, ‘I have failed,’ CEO Rangel says

posted by Rich Miller
Tuesday, May 28, 13 @ 10:50 am

Comments

From a financial standpoint this is kind of like a balloon mortgage. I wonder how much the 10% hit amounts to in real money in year 4 and beyond and whether it takes into account increased bureaucratic costs?

Comment by Cassiopeia Tuesday, May 28, 13 @ 10:54 am
Results were just released for California’s Obamacare Exchange showing insurance rates came in up to 30% BELOW comparable private employer rates, even before subsidies. In other words, it’s working exactly as advertised in the largest implementation to date.

Republicans are making another bad and purely partisan bet.

Oh, and you couldn’t be more right about Jack. Vote against Obamacare and Gay Marriage and then run in a Democratic primary statewide? What a dufus!

Comment by Chicago Cynic Tuesday, May 28, 13 @ 10:54 am
It’s the law of the land and people need to accept that and move on and figure out how to implement it. It’s not going anywhere.

Comment by Demoralized Tuesday, May 28, 13 @ 10:54 am
The constant rant of “we do not have to do this now. let’s wait” rang as false as anything ever utter in the House chamber. There is absolutely no evidence that the Republicans would ever back the expansion. I wish they would have just been honest and said they fundamentally oppose the expansion of Medicaid instead of pretending it was a timing issue.

Comment by Montrose Tuesday, May 28, 13 @ 10:56 am
“This is the cornerstone of our President’s agenda…”

Good to see Representative Feigenholtz is an independent thinker not swayed by appeals to logic. Several prominent D.C. Democrats have concluded that Obamacare is a trainwreck waiting to happen, so let’s be sure that Illinois is part of the collision.

It’s not as if Springfield was nearly bankrupt or in danger of failing to meet any of its other obligations.

Comment by Anonymous Tuesday, May 28, 13 @ 10:57 am
Beltway talking-point sturm-und-drang comes to Springfield. Yawn.

I guess the GOP caucus didn’t notice that the Illinois Chamber, Retail Merchants, and Chicagoland Chamber were all on board. They must be big government socialists, too.

http://www.chicagobusiness.com/article/20130518/ISSUE07/305189967/letters-to-the-editor

Comment by wordslinger Tuesday, May 28, 13 @ 11:09 am
How can these legislators and Governor continually screw up a gambling bill for three years straight but yet com back and say they need more revenue to pay the bills! Fire them all!

Comment by Coach Tuesday, May 28, 13 @ 11:10 am
come

Comment by Coach Tuesday, May 28, 13 @ 11:11 am
So, let me get this straight-the GOPers (and Franks) are shameless hacks thinking only of the politics, according to some of you all. What, then, are Rep. Send A Teacher To The Capitol and her cohorts?

Comment by Arthur Andersen Tuesday, May 28, 13 @ 11:16 am
Voted for you, Natalie. Expected better.

Comment by Concerned Observer Tuesday, May 28, 13 @ 11:20 am
Is this vote on the Chamber’s legislative scorecard?

Comment by 47th Ward Tuesday, May 28, 13 @ 11:24 am
Has the United States had an election since the Affordable Care Act was passed?

What was the result of that election?

Comment by Carl Nyberg Tuesday, May 28, 13 @ 11:28 am
I think that I was still in high school when the first proposals to expand gaming positions to benefit the horse racing industry were being discussed. Four decades later, the subject is still being kicked around and there is no end in sight.

Comment by Spinning Top Tuesday, May 28, 13 @ 11:28 am
How is Obamacare a trainwreck?

Or is this one of these games where people repeat propaganda over-and-over and hope to manufacture a partisan reality based on BS.

Comment by Carl Nyberg Tuesday, May 28, 13 @ 11:30 am
@Carl Nyberg:

The negative comment is a paraphrase of the quote US Senator Baucus (D-MT) addressing the merits of Obamacare. He is retiring and has been critical of the healthcare law which he previously supported. If you dislike the rhetoric, blame the Democrat who provided it.

Baucus is not alone other Washington Democrats are expressing doubts too. Maybe they felt that the US Supreme Court was going to bail them out by striking the law, but they guessed wrong.

Comment by Spinning Top Tuesday, May 28, 13 @ 11:35 am
Im still waiting for my fellow retirees,(the conservative ones) to admit that the ACA with its elimination of pre existing conditions, will enable them to give up State Health Ins and choose the COLA , knowing they will be eligible for Ins.. Hold your nose and repeat…thank you Obamma

Comment by anotherretiree Tuesday, May 28, 13 @ 11:39 am
I know how much Rich hates it when we talk national stuff in a partisan way, so let me try and inject a balanced answer to Spinning Top and Carl.

Obamacare is a small term that encompasses a HUGE array of programs. Some look like they could work out fabulously well (such as the California Health Exchange coming in with plans much cheaper than private businesses get). Others that look like they could be an implementation train wreck which is what Max Baucus was talking about (mainly related to implementation of aspects of the program and eligibility verification for the poor).

There are clearly aspects of this law that will make an enormous difference in the lives of millions of Americans (no pre-existing conditions, no lifetime cap, ability to get subsidies for insurance, etc). But change of this magnitude is complicated. Only time will tell how the whole thing plays out.

Comment by Chicago Cynic Tuesday, May 28, 13 @ 11:50 am
This is a good idea that will help people.

How are we paying for it?

Comment by Formerly Known As... Tuesday, May 28, 13 @ 11:51 am
The GOP tried and failed to kill Social Security in its infancy many times. They thought then this would be a winning political strategy. They were wrong on SSN, and wrong on ACA.

I guess that conservatives have more problems accepting change than the average voter.

Comment by walkinfool Tuesday, May 28, 13 @ 11:51 am
The Medicaid expansion is going to cost the state a lot more than is expected. The Civic Federation did a pretty extensive piece about this already.

Those who don’t understand math shall inherit the State of Illinois. Addition and subtraction is NOT a right-wing conspiracy.

http://www.civicfed.org/iifs/blog/medicaid-expansion-illinois-costs-and-benefits

Comment by YAYLisa Tuesday, May 28, 13 @ 11:55 am
The Civic Federation recommends adoption of the expansion bill: http://www.civicfed.org/iifs/publications/fy2014recommended

Comment by Rich Miller Tuesday, May 28, 13 @ 12:02 pm
Also, if federal funding falls below 90 percent, the program is ended.

Comment by Rich Miller Tuesday, May 28, 13 @ 12:13 pm
I’m hoping that we can forever close the door on not having national health insurance. I’m glad to see that the marketplace is putting downward pressure on insurance premium prices, but from what I read, populous states may have lower premiums due to more insurance companies in the exchanges.

I changed jobs and will start processing Medicaid applications for individuals, as part of the ACA. I hope to share what I will learn in this new gig.

Comment by Grandson of Man Tuesday, May 28, 13 @ 12:13 pm
The Republicans forget Obamacare is the law of the land.
They should be looking for ways to clean it up and make it better. Instead they prefer to stick the heads in the sand and maybe it will go away.
California has proven it will drive costs down.
They don’t have to worry about health care because they have the best that money can buy and the taxpayers pay for it.
If it was on their dime thing would change.

Comment by Mokenavince Tuesday, May 28, 13 @ 12:16 pm
What is Illinois status regarding insurance exchanges? Has it been decided if Illinois will start their own exchange or let the Feds exchange be used ?

Comment by MOON Tuesday, May 28, 13 @ 12:21 pm
Funding will never fall below 90% Rich. Not as long as people like Uncle Ben and the treasury control the printing presses. As far as SSN goes the problem is with medicare not social security. Ernst and Young did and extensive report on the ACA.

Comment by Friedman Tuesday, May 28, 13 @ 12:29 pm
My question is, will the Chamber seek to neutralize the Navigator program in order to funnel non-covered employees into Medicaid?

Comment by Election Lawyer Abe Tuesday, May 28, 13 @ 12:31 pm
I mentioned this in another post, but it’s intriguing. In Oregon, the state is trying to get ahead of Medicaid costs via a community care organization. This organization is planning on doing preventive care such as checking on Medicaid recipients in the community and providing them with services that might avert more-costly medical treatment.

It’s very ambitious and may or may not work, but I think we should be working on creative ways to provide services while keeping down costs and saving taxpayers money.

Comment by Grandson of Man Tuesday, May 28, 13 @ 12:40 pm
Franks always thinks of bigger things, but he does stay responsible to his district. He’s thinking just as much about Joe Walsh making noise to run against him as anything.

Comment by L.S. Tuesday, May 28, 13 @ 12:43 pm
I find it incredibly typical of Republican partisans to pull some quote but they don’t know boo about the policy.

Republicans should not be in governing positions at all until they show the maturity to govern.

Comment by Carl Nyberg Tuesday, May 28, 13 @ 1:47 pm
For more on the Senator Max Baucus “train wreck” quote referenced by Spinning Top above - and why in my opinion ST grossly distorted the context of Baucus’s remark - you can read David Weigel at Slate:

http://www.slate.com/blogs/weigel/2013/05/24/the_secret_history_of_max_baucus_s_train_wreck_quote.html

Comment by ZC Tuesday, May 28, 13 @ 1:57 pm
Quotes have context? Who knew?

Comment by Carl Nyberg Tuesday, May 28, 13 @ 3:00 pm
With regard to the California exchanges–it may not be a totally unmitigated success. The lead paragraph in an LA Times story “California’s health insurance rates for a new state-run marketplace came in lower than expected this week, but one downside for many consumers will be far fewer doctors and hospitals to choose from….Another major insurer in the state-run market, Blue Shield of California, said its exchange customers will be restricted to 36% of its regular physician network statewide.”

another key graph…

“Meanwhile, some insurance agents said it’s hard to judge these proposed prices in the state exchange without knowing what’s on the menu in terms of available providers.

“Trying to determine whether these rates are low or high without knowing the provider networks is like trying to tell the value of a car when you can only see the tires — you don’t know if you are looking at a Ferrari or a Yugo,” said Bruce Jugan, an insurance agent in Montebello and president of Benefitscafe.com, which sells health insurance to individuals and businesses.”

http://www.latimes.com/business/la-fi-health-rates-deals-20130525,0,4396720.story

Its also worth reading this http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/28/california-didnt-have-rate-shock-but-california-isnt-like-most-other-states/ to get a sense of why California may not exactly be replicated elsewhere.

These may all be worthwhile tradeoffs. I leave that to others to argue. I only note that there will be tradeoffs in California.

Comment by Gurnge Tuesday, May 28, 13 @ 3:28 pm
One thing thay gets lost in reporting on obamacare is the fact there is a sizable chunk of folks who don’t like obamacare for it not being liberal enough. Cnn just came out with a poll announcing 54% oppose obamacare. Then you read the article and 16% oppose it because they want a public option or medicare for all. Its very disappointing that so many of these folks opportunistically put a D after their name and then run scared from obamacare just because of the empty hype of the opposition to it.

P.s. a question for the advertising dept. RE: aarp’s ad - were voters UNDER 18 years old polled and did their results really skew that differently tha voters 18+? just wondering.

Comment by hisgirlfriday Tuesday, May 28, 13 @ 4:23 pm
HisgirlFriday is smarter than the average bear, the average dude, the average girl and anyone else who has s— for brains.

I’m at a loss.

If someone promised you that they’d give you $10 a year for three years, and then nine dollars for every one you put up after that, to get something done that you wanted to do anyway, wouldn’t you do that?

No? Did you hit your head real hard?

Can no one see that this is a small way of clawing-back all the money that the Yankee states have been shelling out for the rebs in Texas and Lousiana, where the Big Bains there think its good business sense to treat their folks like s-==?

Comment by wordslinger Tuesday, May 28, 13 @ 6:59 pm
–One thing thay gets lost in reporting on obamacare is the fact there is a sizable chunk of folks who don’t like obamacare for it not being liberal enough==

Liberal, it was not.

Like Medicare Part B, Obamacare was a huge score for the powers that be in pharma and medicine. On your dime.

Eventually, we’ll get our stuff together and figure out that medicine is a utility, like TR layed it down back in the day, and not give the cream to the wise guys.

Comment by wordslinger Tuesday, May 28, 13 @ 7:10 pm
Also the nonsense about anti-small business Obamacare gives generous tax breaks to the under 50 which is most and with the exchanges its the most pro small business bill I have seen in years Everything else is for the benefit of the giant Corps. They just con the small business were are on the same side -yeah sure

Comment by RNUG Fan Tuesday, May 28, 13 @ 8:49 pm
===Also, if federal funding falls below 90 percent, the program is ended===

Federal law does not allow this, so it’s a meaningless provision.

Comment by Big Guy Tuesday, May 28, 13 @ 9:00 pm