Two Steps Back for Health Care Push

Add comment May 5th, 2008

Try as he might to unilaterally expand the availability of state-subsidized health care, Gov. Rod Blagojevich is pushing his program forward with one step forward, two steps back.

Blagojevich kicked off spring session last year by calling on lawmakers to approve his version of universal health care backed by the largest tax hike in Illinois history — a tax on the gross receipts of Illinois businesses. But the House shot down his gross receipts tax, and the governor failed to shepherd his health care plan through either chamber of the Legislature — even the Senate, where his ally Emil Jones Jr. is president.

Onward to August, when Blagojevich used his veto power to slash more than $460 million in grants and other spending — pork, he called it — from the budget that lawmakers belatedly approved. He focused his cuts on grants secured by political adversaries, sparing those earmarked by political allies.

The governor insisted at the time that he would use the money to support his health care plan. Never mind that lawmakers, whom under the state Constitution have the exclusive power to “make appropriations for all expenditures of public funds by the State,” had not appropriated the spending for his health care plan; the governor insisted he could unilaterally redirect the spending for his health care plan anyway.

“In short, I’m cutting pork and special interest spending, and in its place, I’m using the legal authority that I have to expand health care,” the governor said.

In November, the governor’s administration filed an “emergency” rule to vastly expand the state’s FamilyCare program, pushing Illinois toward his goal of universal health care. It said the “lack of access to insurance has reached a crisis level requiring immediate action.”

Fast forward to this spring, when the governor’s aides applauded him for saving the budget from an even larger budget hole. When the governor’s office announced that the budget has a $750 million deficit for the fiscal year ending June 30, they said the hole would be far larger if the governor hadn’t taken fiscally prudent action last August and vetoed more than $460 million in spending.

The governor’s budget proposal, delivered in February, said this about his August veto:

Anticipating a potential budget deficit resulting from
the General Assembly’s budget passed in HB3866,
the governor exercised his amendatory veto authority
to reduce appropriations by $463 million. This
reduction was implicitly anticipated by the General
Assembly, which passed a budget that required the
state to not spend over $830 million in appropriated
spending in order to meet the their own overly
optimistic revenue projections.

In other words, the governor said in August that he was shifting the spending to his own priority (despite the absence of an appropriation allowing him to do so), and then he said in February that he saved the state a bunch of money by cutting the spending (though, by his reckoning, the state remained $750 million in the hole). Hindsight is 20/20, I suppose, particularly when it serves the governor’s interest.

Well, it turned out the governor’s “emergency” rule, and a subsequent permanent rule, did not successfully facilitate the expansion of health care. A special panel of lawmakers charged with reviewing the governor’s rules rejected both of those rules. And in mid-April, a Cook County judge followed the panel’s lead and also beat back the governor’s program.

As I reported in my Saturday column, even as the governor insisted on the expanded program embodied in his emergency and permanent rules, his strategy threw into question coverage for roughly 25,000 people who previously enjoyed it.

When the Blagojevich administration moved last November to expand health care to folks earning far more money than these 25,000 people, it used them as bargaining chips. When the administration ultimately failed to implement the governor’s larger program, it left health care for the 25,000 lesser-earning individuals in limbo.

“They wanted to piggy back the governor’s expansion onto the people that really faced some hardship here and they put everybody in an all-or-nothing proposition,” said Rep. John Fritchey, D-Chicago.

Meanwhile, the administration has instructed health care workers to stop enrolling people in the program set forth in the emergency and permanent rules. Its stop-new-enrollment memo also covered the group of 25,000 people who had health care before the governor launched his controversial rules in November. (The memo speaks in terms of a participant’s income as it relates to the federal poverty level. To decipher that code, go here and scroll down to the chart.)

As the Register Star reported on Saturday:

In a memo dated April 22, the administration ordered health-care workers to not enroll any more adults, age 19 or older, earning more than $13,832 annually. Pregnant women may earn up to $20,800 and still qualify, the memo said.

The shift is consistent with a Cook County judge’s April 15 order blocking the governor’s push to make health care available to adults earning up to $41,600.

Still, it marks a retreat for Blagojevich. Since last fall, he has pushed his expanded program forward even though lawmakers refused to authorize the spending and a special legislative panel twice rejected rules that his administration advanced to enact it anyway.

For background on the court case, see the Web site of Richard Caro, a west suburban attorney who initiated the lawsuit against the governor’s expansion.

On Friday, I placed a series of questions by e-mail and phone with Annie Thompson, spokeswoman for the Illinois Department of Healthcare and Family Services. I still don’t have answers.