Tuesday, February 26, 2008

"My way"

I have Frank Sinatra’s “My Way” stuck in my head. It’s a reoccurring theme in the Statehouse, especially on days like today. Two House Democrats are trying to take a different route than the governor to expand state-sponsored health insurance to 147,000 adults. They’re using legislation, something Gov. Rod Blagojevich tried to do last year but got nowhere. When that didn’t work, he tried using his administrative authority. He repeatedly got blocked there, too. It happened again this morning, but the administration is moving ahead, anyway, stating that it can afford the expansions and that it expects federal approval and matching funds to come through.

This morning, the Joint Committee on Administrative Rules, a bipartisan legislative panel that reviews executive rules, again rejected and suspended the Department of Healthcare and Family Service’s effort to expand a health insurance program to two groups of people: 1) up to 20,000 individuals making up to 185 percent of the federal poverty level who were covered under the State Children’s Health Care Program; and 2) a new group of 147,000 adults who make up to 400 percent of the federal poverty level.

Background resources: See the administration’s original proposal in the November 26, 2007, Illinois Register, and scroll down to No. 15854. You can read more about the governor’s attempt to expand health care in my February column of Illinois Issues magazine and in a November blog.

Rep. Lou Lang, a Skokie Democrat and JCAR member, summed up his constitutional concerns and frustrations during the hearing. “Under what chutzpah do you come to this body and ask us to approve a rule that we already rejected when you had the unmitigated gall to put 3,300 people on a program that you ask us to approve that we did not approve? Why are we here?”

“To have an open forum, to hear comment, to participate, to try to make sure that we’re implementing, to listen to concerns,” replied Tamara Hoffman, chief of staff for the Department of Healthcare and Family Services.

The legislation proposed by the two House Democrats would do exactly the same thing to cover 147,000 more adults. The difference is that it would require the full General Assembly to approve the money allocated to the program every single year, allowing them to adjust for budget shortfalls.

“If it’s going to happen, this is how it should happen,” said Rep. John Fritchey, a Chicago Democrat sponsoring the measure with fellow Democratic Rep. David Miller of Lynwood, in a Statehouse news conference.

Both said they hope legislative hearings would be more successful in getting answers from the administration. Hearings could vet out the details so the full General Assembly, rather than a 12-member panel, could decide whom to cover, at what level to cover them and how to pay for it in the long run. “Going through the legislative process I think empowers the voters,” Miller said. He added that maybe 400 percent of the federal poverty level isn’t the threshold. Maybe it’s less, but that’s what the hearings would aim to figure out.

Fritchey added that the legislation could buffer 3,300 new enrollees, a number given by the administration today. Those people potentially could lose FamilyCare benefits if a judge rules that the governor violated his constitutional authority to expand a health care program without legislative approval. Read background of the lawsuit filed against the administration here. If a judge did rule against the administration, however, Rep. Rosemary Mulligan, a Des Plaines Republican and JCAR member, said it’s more likely that the Department of Healthcare and Family Services wouldn’t kick anyone off of the health insurance program; it simply would eat the cost and make up for it elsewhere. Hoffman said the department won't speculate about what would happen if the lawsuit overturns the administration’s authority to expand the program.

Department officials also said it has the money in its current budget to cover the expansions, but they didn’t specify. The General Assembly never approved spending authority specifically to cover the expanded health care programs. Department heads left without answering questions after the vote.

Eight JCAR members rejected the administration’s rule. Two Republican members went against the grain. Mulligan and Rep. Brent Hassert of Romeoville said they’re not happy with the administration’s lack of answers and don’t believe it has the money to cover the expansions, but they do believe the department has the authority to do expand FamilyCare. That’s because, Mulligan said, the General Assembly approved that authority in 2006. Hassert added that the JCAR hearings on the governor’s health care plans are symptomatic of the ongoing game of politics between the governor and House Speaker Michael Madigan.

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