While a final list of cuts hasn't been determined, coming
into focus are possible points of agreement on reductions in
spending for the health insurance program for nearly 3 million poor
and disabled Illinois residents, according to interviews with
committee members and committee background materials obtained by The
The group plans to meet again Tuesday. Under
tangible benefits such as visits to chiropractors and setting
limits on dentures and eyeglasses. For people with incontinence,
reducing the monthly ration of diapers.
More than 26,000
parents with incomes more than 133 percent of the federal
poverty level may lose their coverage in a program called
Gov. Pat Quinn set the $2.7 billion target in his Feb. 22 budget
address, warning that Medicaid was "on the brink of collapse." He
charged a four-member work group with finding a solution. At the
time, his administration suggested tightening eligibility, reducing
payments to hospitals and doctors, and cutting optional benefits to
reach the nearly 20 percent spending cut.
Earlier, Quinn's administration floated a different proposal that
included $1.3 billion in cuts to Medicaid program spending, with the
rest of the $2.7 billion coming from a $1-a-pack increase in the
cigarette tax and rate cuts to health care providers, according to
Sen. Heather Steans, one of the Democrats on the Medicaid committee.
"When you look at what it takes through just cuts to get to $2.7
billion in one year, it's impractical," Steans said. "It's hard to
maintain program integrity."
Rep. Patti Bellock, a Republican on the committee, is pushing for
more cuts and doesn't want to raise cigarette taxes or cut payments
to providers, she said.
"The governor wanted to come forward with a plan this week and
had been encouraged by some of the (legislative) leaders to do
that," Bellock said. "I've just been trying to push them more. ... I
think we can find some more reforms."
Republican Sen. Dale Righter said a cigarette tax is not the
right approach when the goal is to reduce the size of the Medicaid
"This problem is bad enough that everything has to be on the
table," Righter said. But a cigarette tax is "a way to continue to
spend more." He's also resisting severe cuts to provider payment
With or without a cigarette tax or rate cuts to doctors and
hospitals, the list of possible cuts to Medicaid programs is long.
It includes new ideas suggested by numerous health care groups and
the Department of Healthcare and Family Services.
[to top of second column]
Among the ideas:
Repeal or suspend
a law requiring a palliative care program for dying children, to
save $4.5 million.
insurers in Illinois to cover the cost of all essential medical
services for children with special health care needs, to save
more than $300 million annually.
eyeglasses to one pair every two years and adult dentures to one
set every 10 years.
Limit diapers for incontinence to 200
per month per patient, to save $5 million.
The Illinois Hospital Association has said cutting payment rates
to hospitals and other health care providers should be a last resort
and has questioned the size of the target for spending cuts.
"A $2.7 billion cut in Medicaid would jeopardize patient access
to health care and people would suffer," said hospital association
spokesman Danny Chun. "We do commend and appreciate that the
governor and General Assembly are willing to look at revenue
options, because so much is at stake."
Advocates for the elderly, poor and disabled worry about how the
cuts will affect people. David Vinkler of AARP is concerned the
committee may equate painful cuts with making responsible budget
decisions. He said eliminating some benefits may actually increase
"You can't just punch seniors in the face and say we saved
money," Vinkler said.
Rep. Sara Feigenholtz, a Democrat on the committee, said
achieving $2.7 billion in cuts without "severe rate cuts" to
providers will be difficult. She wouldn't comment directly about a
cigarette tax. "The potential of lessening the rate cut blow is
mitigated by the potential for other revenues. The question is: Are
the Republicans going to help us get there?"
Feigenholtz and the other committee members are holding out some
hope for an agreement.
"It's still the second inning," she said.
A Quinn administration spokesman said a proposal will be
announced "once we have one."
"The status quo is not an option," said Department of Healthcare
and Family Services spokesman Mike Claffey. "Saving the Medicaid
program is a top priority because if nothing is done, the system
By CARLA K. JOHNSON]
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