Lawmakers rush to reform Medicaid, workers' comp, education -- show or substance?

[December 18, 2010]  SPRINGFIELD -- Illinois lawmakers appear to be skipping a few gears in accelerating toward reform packages on such complex issues as Medicaid, workers' compensation and education reform.

Committees created by both the House and Senate have been meeting throughout the month, with an eye toward crafting legislation for the lame-duck session set to begin Jan. 3 -- now a mere two weeks away.

But a longtime observer of Illinois politics said the speedy timeline is about right for the state legislature.

"It's not a deliberative process at all," said Kent Redfield, a professor of political studies at the University of Illinois Springfield. "As soon as they've got something, they'll run with it."

That point appears to be lost on some advocates.

"We've thrown open the hood. We're looking at an incredibly complex engine with dozens, if not scores, of moving parts," Illinois Hospital Association general counsel Mark Deaton told House lawmakers studying workers' comp. "The last thing you want to do is just start yanking wires and hoping that you yank a wire that will fix things."

Several wires have already been scrutinized in all three issues.

Medicaid reform talks have focused on tightening eligibility, since the bulk of the federal health care law is set to hit in 2014, bringing an estimated 700,000 new participants into the state-federal health care program. Lawmakers also are looking at managed care for Medicaid -- assigning Medicaid recipients a "medical home," much like an HMO.

About 195,000 of Illinois' Medicaid recipients are enrolled in voluntary managed care, and a pilot program set to begin next year will serve an estimated 40,000 elderly and disabled recipients.

As director of the overseeing Department of Healthcare and Family Services, Julie Hamos told lawmakers that policymakers, providers and advocates will all be clamoring to get a piece of the action if the pilot program is expanded to cover all of the state's 2.8 million Medicaid recipients.

"I am here to ask you for the backup," Hamos said. "We need the backup."

The key players in the workers' comp debate are simply asking for an agreed bill process out of the reform talks.

The complex issues of distinguishing between a degenerative physical condition and an on-the-job injury, and using standardized physical impairment guidelines have ignited fiery disagreement between business and labor groups that can only be resolved through negotiation, just as in the past, according to a labor leader.

"Everybody gave up something in order to come out with a bill at some point," AFL-CIO President Michael Carrigan told lawmakers.

Redfield said he believes a reform bill will surface for both Medicaid and workers' compensation, for both fiscal and political reasons.

"The Democratic leadership is trying to get costs under control," he said. "And Speaker (Michael) Madigan and Senate President (John) Cullerton need to get Republican votes for budget cuts and raising taxes. They don't want to wear the jacket alone."

Mike Lawrence agreed. The longtime former Statehouse reporter and retired director of the Paul Simon Public Policy Institute said reforms in Medicaid and workers' comp will give Republicans some cover.

"Republicans could defend their votes on a tax increase with significant reform on these issues," said Lawrence, who also served as an aide to former Gov. Jim Edgar and is now a political columnist.

But Redfield doubts the call for education reform is real.

Draft House legislation calling for tenure reform, restraints on the power of seniority during teacher layoffs and an easier dismissal process for poorly performing teachers has been making the rounds of officials, teachers' unions and education reform advocates, sparking frantic debate at a House committee on Thursday.

It's most likely all for naught, Redfield said, and most likely all politics.

All public employee unions -- especially the state's two teachers' unions -- are still chafing at last year's whirlwind passage of pension reform legislation, Redfield said. It showed up in a lack of campaign contributions and participation from teachers' unions in the House Democratic targeted races in the November election, Redfield said, after crunching the data.

That apparently didn't sit well with the speaker of the House, he said.

"Madigan's firing a shot across the bow," Redfield said of the creation of the House education reform committee. "At the end of the day, you have to deal with the speaker and the Senate president."

But at least one union representative at Thursday's committee meeting appeared to have an inkling that something was awry with the frantic pace of education reform talks.

Audrey Soglin, executive director of the Illinois Education Association, reminded committee members of the group's collaborative efforts last spring to create and pass legislation linking teacher evaluations with students' performance on standardized tests, as part of a failed attempt to win federal money for the state.

"It does make everyone watching this today wonder what the true motivation is -- real change for education for kids, or something else," Soglin said.

[Illinois Statehouse News; By MARY MASSINGALE]