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* The governor proposed doubling state-subsidized health care without any formal announcement or actual legislation…
Gov. Rod Blagojevich’s administration intends to grant state-subsidized health care to another 147,000 adults, saying poor access to insurance “has reached a crisis level requiring immediate action.”
The administration’s new policy more than doubles eligibility for a health care program known as FamilyCare.
A family of four with a combined income of up to $82,600 — or up to 400 percent of the federal poverty level — can now join. Previously, income for a family of four had to be $38,203 or less, or up to 185 percent of the poverty level. The plan is part of Blagojevich’s campaign to make government health care available for anybody without private insurance.
On Wednesday, the administration filed an emergency rule, which surfaced Thursday as Blagojevich visited Washington to promote his health-care efforts.
Local Republicans were not impressed.
“It’s clearly an abuse of the emergency rule process because this is clearly not an emergency — expanding a government program and doing it around the legislative process,” said Sen. Dave Syverson, R-Rockford.
* This is from an e-mail that a member of the Joint Committee on Administrative Rules sent me last night. JCAR will have to approve the emergency rules…
HFS filed an emergency rule to expand family care to cover people up to 400% of the federal poverty level. This would pick up an additionjal 147k people. Oh yeah, at a cost of $367.5M. With no federal match. And potentially further increase the payment backlog to providers, which ironically could lead many of them to not take new patients, or even cut existing ones. Unreal.
Interesting that he makes this major policy decision with NO press release but piggybacks it onto his DC trip.
This sets up the JCAR battle that people have been waiting for. (JCAR is meeting on Tues.) I don’t even think he wants to do it, but just wants to be able to demagogue on the issue that he cares more about health care than anybody else does. If only the legislative process wasn’t so inconvenient
[Some emphasis added]
Demagoguery over substance? Never. Not our governor.
* Meanwhile, Gov. Blagojevich was asked yesterday why he didn’t support single-payer health insurance…
“So much of what you do in government is done through political realities,” Blagojevich said. “The art of politics in government is the recognition of what is possible.”
He knows the tune. He just can’t dance to it.
*** UPDATE *** Chambers follows up on his intial story…
Gov. Rod Blagojevich’s latest plan to expand health-care coverage will cost $367 million annually, far more than his administration acknowledged, key lawmakers said today. […]
The Blagojevich administration insisted Thursday evening that the plan would cost $43 million through June 30, the end of the fiscal year.
But Rep. John Fritchey, D-Chicago, said his staff analysis shows the expansion would cost $367 million annually once it’s fully implemented. Sen. Dan Rutherford, R-Pontiac, concurred.
Fritchey said the $43 million figure is misleading even as it pertains to this fiscal year.
He said the state stands to lose $21.5 million in federal reimbursement dollars when the administration moves the $43 million from the existing Medicaid program to cover the expansion startup.
posted by Rich Miller
Friday, Nov 9, 07 @ 9:05 am
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Just a reminder -
JCAR doesn’t “approve” emergency rules. The emergency rule is in effect right now.
JCAR can only prohibit the rule, if they determine the rule is a threat to the health and safety of the people of Illinois. Though they will probably say they are blocking it “because it should go through the legislative process,” that isn’t really their call.
Plus, take another look at the article. I don’t know if this was intentional by Blago or not (probably was), but if JCAR does prohibit the rule, they will in effect be kicking “15,000 - 20,000″ people who are on the program right now. Those people would apparently get kicked off because of the SCHIP stuff at the federal level.
Comment by GoBearsss Friday, Nov 9, 07 @ 9:19 am
Why is in Washington D.C.? To promote a health care plan for Illinois? What the heck?
Comment by PJ Friday, Nov 9, 07 @ 9:19 am
Again, it would appear he’s decided to pick a fight, this time with JCAR, and by extension with Madigan. This constant desire to engage in battles rather than engage in leadership has become incredibly tiresome. Of course, after 5 years, we’re all familiar with this version of governance.
This certainly was not the legislative intent for the “emergency rule” allowance granted to HFS, and I’m pretty sure JCAR will instruct the administration to file their rules using the standard process, which allows for a review and comment period before a JCAR vote and before implementation. That allows ample time to get formal responses from the administration regarding what legislative action prompted the need for this rule change and to hear exactly how HFS will expect to pay for this expansion.
Comment by Budget Watcher Friday, Nov 9, 07 @ 9:29 am
“I’m pretty sure JCAR will instruct the administration to file their rules using the standard process”
Again, I don’t think they have the authority to make that request. They can only prohibit the rule if it is a threat to the public’s health and safety.
Comment by GoBearsss Friday, Nov 9, 07 @ 9:32 am
I truly think this guy is a sociopath. This isn’t name calling, but could be a real disorder.
Online I found these traits and I feel he meets a lot of them by his behavior:
http://www.hss.caltech.edu/~mcafee/Bin/sb.html
Comment by Lurking moderate Friday, Nov 9, 07 @ 9:36 am
Did the leaders teleconference even happen yesterday with him in D.C.?
Comment by Anon Friday, Nov 9, 07 @ 9:40 am
Not true GoBearsss. The administration is allowed to file emergency rules in order to protect the public’s health and safety or in response to state or federal statutes that would necessitate an emergency file. Since there’s no federal mandate and obviously no state legislative mandate, there must be evidence of immediate threat to the public health or safety of our citizens. If not, then the emergency rule provision can be effectively denied.
JCAR, btw, is 3 members from each party caucus, so it’s possible that 6 repuiblicans and 3 House democrats can block this rule. It takes 8 to do this.
Comment by Budget Watcher Friday, Nov 9, 07 @ 9:45 am
don’t assume JCAR will reject this. The last one lost because of the obvious link to GRF Member Projects, and many of the recipient JCAR legislators recused themselves (or were removed by their leader) and had substitute caucus members vote in their place. With this delay in time, these same JCAR members may choose to vote with the Governor.
Comment by capitol view Friday, Nov 9, 07 @ 9:46 am
Look in the administrative code, section 230.400 “Review of Emergency Rulemaking - Criteria for Review”
What the code says:
1) Does a situation exist that reasonably constitutes a threat to the public interest, safety or welfare and that requires adoption of the rule upon fewer days’ notice than is required by Section 5-40 of the Act?
It doesn’t say “does the rule constitute a threat to public safety or welfare.” It says does a situation exist where there is a reasonable threat to the public interest, safety and welfare where it is necessary to adopt the rule.
Huge difference. I think the answer is no. And section 230.600 clearly says that if JCAR objects, and 3/5 of JCAR votes to suspend , then the rule is suspended.
I don’t think this rule is going anywhere. It will be DOA Tuesday when JCAR meets.
Comment by Anon from BB Friday, Nov 9, 07 @ 9:51 am
Actually, Blagojevich should of said “corruption in my administration has reached a crisis level and requires immediate action.” “So, I will being leaving the United States permanently”.
Comment by Carlos C. Friday, Nov 9, 07 @ 9:52 am
Another amateur response to a professional obligation. As a former JCAR staffer, I am inherently familiar with the process and, based on the lack of statutory authority, I predict JCAR will fufill its statutory responsiblity and stop this nonsense. I also predict that some members of JCAR will file legislation to amend the Illinos Administrative Procedures Act (spells out the process for rule filing)to clarify legislative intent and definitions of “emergency rules”. A serious argument could be made that the Governor has abused his power in numerous JCAR emergency rule filings. It’s unfortunate that the Senate Dems on JCAR will be placed in precarious position to either defend the Governor or vote their conscious and uphold the statutory obligations they have with respect to the JCAR process. The only emergency in this situation is the Governor has apparently continued a pattern of misfeasance and abuse of power.
Comment by DC Friday, Nov 9, 07 @ 9:55 am
I think it is clear from the article and other things that have been said that they see the 15k-20k people losing their healthcare as an emergency.
But, in the end, none of this discussion matters. The decision is Madigan’s to make. He put Lou Lang on JCAR to specifically vote against all of Blago’s health stuff. And you know Fritchey will block any healthcare expansion, too.
There’s your 8.
They will both find some excuse to block it and then look good back home.
And then the sun will rise another day.
Comment by GoBearsss Friday, Nov 9, 07 @ 9:58 am
GoBearsss,
Obviously, a rule change could be drafted, if necessary, to protect the current SCHIP parents, the 15-20k that you refer to, without adding an additional 145,000 people. However, I doubt that a rule change is necessary since the state already provides coverage. The federal change doesn’t prohibit states from covering SCHIP parents, it simply stops the federal matching funds. Now if the Governor wants to state-only fund those parents already receiving coverage, that’d be a pretty easy sell.
Comment by Budget Watcher Friday, Nov 9, 07 @ 10:14 am
LOL!!! Yeah he definitely can’t dance to it. I suppose what he’s doing after his initial proposals fell on their faces is out of tune as well.
Comment by Levois Friday, Nov 9, 07 @ 10:19 am
He is back benching again, stirring up trouble and looking for headlines. He is not doing his job. I just don’t think he knows what his job is.
Comment by VanillaMan Friday, Nov 9, 07 @ 10:38 am
What the hell, it is only money — our money unless Blago has a printing press
Comment by Truthful James Friday, Nov 9, 07 @ 11:00 am
Did Chuckie Blagojevich take his newly refurbished plane to Washington D.C.? What was the price tag on that little upgrade?
I’ll bet it’s real nice now.
Comment by Sky King Friday, Nov 9, 07 @ 11:21 am
Against better judgment, let me attempt to quickly weigh in. I, and every other member of JCAR, will base our decision upon the procedural aspects of the filing of the emergency rule. Just because the end goal is laudable does not mean that you can use any available means, legal or otherwise, to attain it.
What I really respect about JCAR is that the members consistently put policy and the integrity of the process well before politics, as it should be.
I can also tell you that no member of JCAR with whom I have spoken has had any communication with the Administration regarding this issue.
It is troubling that there would be an attempt to make this significant a change to our state’s policies and practices without any consultation with the Legislature. Just as the administration cannot circumvent the Legislature, nor can it circumvent JCAR.
I will also say that I have not been given any directions on how to vote on this, or any other JCAR matter by the Speaker, directly or indirectly. I believe that the same applies for my HDem colleagues.
I fully support meaningful access to health care for all Illinoisans. That being said, if the administration can demonstrate that the filing of the emergency rule was legally and procedurally proper, I will support it. If they can’t, I won’t. It is as simple as that.
I’m not going to be near a computer, so I won’t be able to reply to any responses for the rest of the day, but I just wanted to share my thoughts with everybody.
And Budget Watcher brings up a very important point. The administration could move to protect the SCHIP enrollees without tying it to this major expansion. If they want to roll the dice on an all or nothing proposition, it is them and not JCAR that is putting those enrollees at risk of losing their coverage.
This is far too real and important an issue to play politics with. I hope that they realize it.
Comment by Rep. John Fritchey Friday, Nov 9, 07 @ 11:57 am
Isn’t there a reasonable chance that whoever is elected president next year will put through some kind of universal health care… probably a public private mix of some kind. It definitely won’t be single payer. So Illinois may end up just starting a little earlier for the newly eligible local population. One hope that the program will be structured in such a way as to be able to take immediate advantage of any new, universal national health care provisions so that Illinois’s beleagured taxpayers don’t end up paying double.
Whatever the cost, it appears that Blago believes he has the money. And I’d certainly rather spend it on improved health insurance access to middle-income families than on higher salaries for greedy school administrators, bridges to nowhere and other pork projects, and so on. Or on huge salary increases for Illinois legislators and
overpaid, low-performing agency department heads….oh, wait, we already spent that.
Comment by Cassandra Friday, Nov 9, 07 @ 12:02 pm
Cassandra, just because Blago BELIEVES he has the money doesn’t make it so! Unless he has far more executive power than we suspect
Comment by Secondhand Bookworm Friday, Nov 9, 07 @ 12:12 pm
I’m shocked that Blago even proposed a rule.
Comment by Lotta Liaison Friday, Nov 9, 07 @ 12:14 pm
BTW - great column today Rich. I’m one precinct worker who will be passing out vote yes on con/con flyers.
Our Governor said this? - “So much of what you do in government is done through political realities,” Blagojevich said. “The art of politics in government is the recognition of what is possible.” - that’s unreal. The man doesn’t even know how to spell compromise let alone say it. I don’t believe that attribution is correct, it must have been a spokesperson who said that. Rod Blagojevich never backs down from his principles! He has some?
Comment by Napoleon Has Left The Building Friday, Nov 9, 07 @ 12:16 pm
“The art of politics”… interesting statement from a guy who gutted appropriations to the Illinois Arts Council. His actions would imply that he’s more interested in the politics of art, not the other way around. If he’s the poster child for the art of politics, we shouldn’t be surprised if he ends up as another starving artist in the next 36 months, unless of course the family real estate business continues to flourish.
Comment by DC Friday, Nov 9, 07 @ 12:25 pm
I believe I am correct that if the Emergency Rule isn’t blocked by JCAR next week, the “Emergency Rule” is only good for 150 days–about 5 months. During that time the Administration would have to file a “regular” proposed rule, and go thru the public comment process, etc. and another JCAR review (at which time JCAR could block the permanent rule). That could make the whole thing another bargaining chip in the Spring Session (or the fall 2007 session, or the continuation of the Spring 2006 session, or any one of the bazillion “special sessions” His Goofiness has thrust upon the legislative branch.
Comment by Ivote Friday, Nov 9, 07 @ 12:31 pm
I agree with the Lurking Moderate that Blago may have sociopathic tendencies based upon his political behaviors. I also used this term yesterday to describe Governor’s Ryan’s protestations of innocence despite the overwhelmming evidence of personal corruption.
However, when we use these loaded terms we should also recognize that neither George Ryan or Rod Blagojevich are all bad - they both have done many good things in their lives/careers. Ryan was,at least, a competent Governor, compared to Blago. Both Ryan nnd Blago love their spouses and families. I don’t dislke either of them personally, although politically I consider them anathemas for different reasons.
Nonetheless,their respective political behaviors do appear to reflect considerable evidence of sociopathy. We’re all complicated people - presumably there’s some good and bad in most of us. But luckily the whole world doesn’t know about our character flaws since we aren’t players on the public stage.
Comment by Captain America Friday, Nov 9, 07 @ 12:45 pm
small b, small w
so now we know where he came up with the money to finance this (the budget cuts)….but who is actually going to pay for this???? the wonderful, generous, taxpayer (you and I)….I would love to be in the position to give money to all who need it….but let’s face it, 40% of the population cannot support the other 60%.
Comment by budget watcher Friday, Nov 9, 07 @ 1:07 pm
budget watcher -
so, it seems your objections to the rule are based more on your political views.
Comment by GoBearsss Friday, Nov 9, 07 @ 1:58 pm
GoBearsss
no, my wallet
Comment by budget watcher Friday, Nov 9, 07 @ 2:09 pm
???
Your taxes aren’t going to go up….
Remember that whole discussion we had yesterday?
Comment by GoBearsss Friday, Nov 9, 07 @ 2:17 pm
To little budget watcher,
Why do you feel the need to use the same blog name as the one I use?
Comment by Budget Watcher Friday, Nov 9, 07 @ 2:21 pm
Framing this as an emergency based on 15-20 thousand parents losing coverage is a stretch. They would not lose coverage, but we would most likely not receive an enhanced match rate from the feds. So instead of a 65% federal match we would receive a 50% match. If this relatively smaller change causes an emergency how do we afford 100% state coverage for 147,000?
This should be denied by JCAR for many reasons, first of which is no funding exists and current statute specifically limits enrollment to 185% FPL.
Comment by My Kids' Dad Friday, Nov 9, 07 @ 2:37 pm
Rod Blagojevich and his administration latest plan to expand health-care coverage will cost $367 million annually, far more than they acknowledged.
Now there’s a SCHOCKER!
Comment by Wow Friday, Nov 9, 07 @ 2:46 pm
“current statute specifically limits enrollment to 185% FPL.”
That is actually 100% incorrect.
Current statute sets a minimum eligibility. From my research today, every expansion in the program has been done by rule - even under Ryan.
In the past 6 or 7 years, the program has gone from 34% FPL to 185% FPL - all by rule.
So, JCAR won’t be able to claim that there is no precedent for this. Their only hope is to quietly strike this down by saying their is no emergency (even though that is stretching their role, as I noted earlier).
Comment by GoBearsss Friday, Nov 9, 07 @ 3:03 pm
No press release on this yet? Maybe I’d better wear my glasses next time I try to gaze into the future
Comment by Secondhand Bookworm Friday, Nov 9, 07 @ 3:10 pm
Fritchey’s estimates assume the money comes from Medicaid.
What if it doesn’t?
Comment by GoBearsss Friday, Nov 9, 07 @ 3:11 pm
GoBearsss,
Actually, state Childrens Health Insurance Program legislation allows adult caretakers with income up to 200% of the FPL to be covered by rule, subject to federal approval of a waiver request. So there is a statutory income cap for SCHIP adults of 200%. Look under the Illinois Compiled Statutes under the Insurance provisions, chapter 215 I think.
However, the Gov’s talking about not asking for federal approval of an expanded waiver, but rather he’s proposing to pay for additional adult caretakers with only state dollars. So the SCHIP statutory cap would not apply.
It does, however, raise the question regarding what authority he has to simply create an adult healthcare program by rule. I didn’t see it in the Covering All Kids legislation, which states the eligibility conditions for children’s coverage.
Comment by Budget Watcher Friday, Nov 9, 07 @ 3:52 pm
that if Rod gets shut down by JCAR, he sues them next. The man is practically begging for an impeachment resolution.
Comment by Who Wants to Bet Friday, Nov 9, 07 @ 4:02 pm
I assume the impetus for this is to move it out of SCHIP? Due to SCHIP no longer being able to cover parents?
I am no legal expert, so I don’t know
Comment by GoBearsss Friday, Nov 9, 07 @ 4:05 pm
I don’t disagree about this not being authorized under SCHIP, but then where does the Governor get his legislative authority to create a new entitlement program? Simply by asserting there’s an emergency threat to the public health or safety?
Honestly, I used to hate playing with the kids who, if they couldn’t win, made up their own rules. It was maddening.
Comment by Budget Watcher Friday, Nov 9, 07 @ 4:14 pm
GoBearsss,
There is a difference between raising eligibility by rule, to levels which are below the statutory cap and raising eligibility by rule to a level which is above the statutory eligibility cap.
Comment by My Kids' Dad Friday, Nov 9, 07 @ 4:25 pm
There isn’t a statutory eligibility cap. That’s the difference.
Look - I don’t know how I turned out to be the defender of Blago’s actions here. I didn’t intend to. I am just trying to dig in and find out mroe about the rule.
Comment by GoBearsss Friday, Nov 9, 07 @ 4:41 pm
I guess what the other poster and I are trying to say is that the only state law that allows HFS to determine eligibility by rule, for adults with children, caps the income limit at 200% of the FPL. That’s in statute. It’s the Children’s Health Insurance Act, found in Ch 215 of the ILCS.
To my knowledge, other than that law, he has no explicit authorization to establish healthcare eligibility by administrative rule for adults with children.
Comment by Budget Watcher Friday, Nov 9, 07 @ 5:25 pm
I think that act just creates the SCHIP funding category of coverage for kids, and doesn’t have any cap on income for parents.
Read the rule again - it has eligibility of 133% to 200% for kids. That doesn’t mean those under 133% (Medicaid-funded), or those over 200% (State-funded), aren’t covered.
Comment by GoBearsss Friday, Nov 9, 07 @ 5:35 pm
Guv is sitting on a new exec.order ” Look at me Mommy, Look At Meeeeee!” He’s just waiting for max PR Splash opportunity.
Comment by A Citizen Friday, Nov 9, 07 @ 5:36 pm
That’s right… a floor value and a ceiling value.
Comment by Budget Watcher Friday, Nov 9, 07 @ 6:22 pm
It looks like the JCAR meeting on Tuesday is going to be in Chicago at JRTC. To show just how crazy this year has been… normally JCAR would meet in Spfld 6 times a year (regular session months of January through May, and again in October or November for veto session) and in Chicago the other 6 times. Because the 2007 session has dragged on so long, this will be the first meeting in Chicago all this year!
Comment by Anonymous Friday, Nov 9, 07 @ 7:07 pm
Just for that funding category. It doesn’t mean parents can’t get medical coverage over 200% FPL.
Comment by John Friday, Nov 9, 07 @ 11:32 pm
John,
Simply put, the Governor would have no OTHER statutory authorization to establish, by rule, eligibility above that ceiling.
Also, HFS appropriations for medical assistance cover Medicaid, SCHIP, and ALL Kids. If the legislation that defines the eligibility parameters for these programs does not allow parental coverage above 200% of FPL, then there would be no way to pay for services using existing appropriations.
Comment by Budget Watcher Saturday, Nov 10, 07 @ 7:03 am
Kurt Erickson of Lee Newspapers (including Pantagraph, Herald and Review, De Kalb Chronicle) has now got several JCAR members on the record saying they will vote to prohibit this rule or predicting that it will be blocked (actually the proper term for an emergency rule is “suspended”)
Comment by Secondhand Bookworm Saturday, Nov 10, 07 @ 7:35 am
Let’s hope they have a clear conscience when they kick 20,000 people off of healthcare then.
Comment by John Saturday, Nov 10, 07 @ 7:50 am
An effective leader would have pursued a legislative remedy to the potential loss of SCHIP coverage for parents. Instead we get a proposed administrative rule that not only preserves, but significantly expands healthcare without legislative authorization and without funding. Leadership without substance.
Comment by Budget Watcher Saturday, Nov 10, 07 @ 8:57 am
Gee Rich, you usually don’t take comments this late into the weekend. You might want to rest up for all the excitement on Tuesday
Comment by Secondhand Bookworm Saturday, Nov 10, 07 @ 9:44 am
I’m sure in his mind Blago sees himself succeeding when Hilary failed and that this is all part of his plan to be positioned as the only Democrat to have successfully adopted universal health care. Ergo, he and he alone should be drafted as the Democratic national candidate next year because he, with his limited power, succeed where others failed. Yes, I truly believe he has (deluded) visions of being the party’s savior next year after the two front runners melt down …
Comment by Another Ex-State Employee Saturday, Nov 10, 07 @ 9:37 pm