Medicaid plan not quite ready

By Ashley Griffin 

Gov. Pat Quinn says he wants lawmakers to address Medicaid reforms by the end of the week. But today, the sponsor of legislation that surfaced yesterday says the bill needs more work.

 In a House committee hearing, Rep. Sara Feigenholtz, a Democrat from Chicago, informed members that Senate Bill 2840, which contains various eliminations, service reductions and other changes to Illinois’ Medicaid system, was not ready for a hearing. “I think we’re moving forward, and we’re doing it well. I’m very optimistic that we’re going to have an agreement very shortly, but as you know, the devil is in the details. There’s a lot of moving parts in Medicaid reform. We just want to make sure that we’ve dotted all of our Is and crossed the Ts,” said Feigenholtz, the bill’s chief sponsor. She said House leadership is also working behind the scenes to make sure the proposal can get the votes needed to pass. “There are a lot of moving parts, I think the leaders continue to meet about making decisions about who's voting for what and putting together roll calls and making sure we’re ready to move forward.” Feigenholtz said they are also considering what parts of the overall proposal, which also includes a cigarette tax increase, to run first. Such an increase is not in SB 2840 and would likely be presented in a separate bill.

She added that she is weighing whether some components of her more-than-400-page bill should remain part of the measure. For example, Feigenholtz said a portion of the legislation that would clear the way for Cook County to take on more Medicaid patients might be removed. The provision would roll back a state mandate against Medicaid growth to allow Cook County to add to the Medicaid rolls 100,000 people who would become eligible in 2014 under the Affordable Care Act. The move to add more enrollees would let Cook County receive federal matching funds for patients who are currently getting free treatment at county hospitals. The measure would not be paid for with tax dollars from outside of the county.

 Cook County Board President Toni Preckwinkle appeared before a Senate committee yesterday to make her case. She testified in support of House Bill 5007, another piece of legislation that would lift the moratorium on Medicaid expansion for Cook County. “It would allow our system…to receive federal reimbursement for a population that we currently serve but who are not covered by any public or private health care coverage plan today,” Preckwinkle said. The federal government would also have to sign off on Cook County taking on additional Medicaid patients.

While Feigenholtz said she did not present her bill today because of “technical” issues, some Republicans have problems with the fundamentals of the overall plan. Sen. Dale Righter, who was a part of a legislative working group tasked with addressing Medicaid, said that Democrats jumped at the idea of using revenue to try to avoid cuts, but Republicans may not back that idea. “I can see where there’s an issue over there. … And it may be time for the Medicaid advisory committee to sit back down again and look for more reductions," he said. “Perhaps if they weren’t so quick to rely on new revenue, we’d be seeing a little more progress now." Righter, a Mattoon Republican, said he does not think there is any support in his caucus for a cigarette tax increase. Feigenholtz said again today that the plan, of which SB2840 would be a part, relies on a cigarette tax increase.

Quinn is pushing lawmakers to approve a solution this week, and take on pension reform, as well. “This is not a time for delay or denial or doing nothing,” Quinn said.

He said he wants lawmakers to deal with pension and Medicaid reform this week, so they have time to work out budget details next week. “We want two things this week — real focus on them. That’s pension reform and Medicaid restructuring.” The budget must be approved by May 31 to pass on a simple majority vote. If lawmakers fail to do that, there is the potential for a long and volatile summer session as Republicans try to wrangle more cuts out of Democrats. “It really comes down to, are we going to make things better for our kids than we found them? If we fail to act this week on Medicaid restructuring and pension reform, we’re letting our kids and their kids down. We have to rise to the occasion,” Quinn said.