Specifically, the Appellate Court ruled that legislation containing the funding sources necessary to pay off the bonding needed to finance the construction plan violated a legal “single-subject” rule that mandates each bill only address a single subject matter. Some of the revenue streams ruled unconstitutional include the legalization of video gaming, tax hikes on liquor, and increased sales taxes on soft drinks, candy and health and beauty products. Also targeted was the increase of annual vehicle registration fees from $78 to $99.
In a statement, Governor Quinn’s office said that while the request for a stay is pending with the Supreme Court, capital projects already in progress will continue as scheduled. The Supreme Court is expected to respond quickly to the request for a stay.
ADOPT MORE STRINGENT SINGLE-SUBJECT RULES
Regardless of how the Illinois Supreme Court may rule, I prefer a very narrow definition of “single subject” and would like to see lawmakers adopt rules that are even more stringent than the Illinois Constitution may require.
In my view, we ought to be much more conservative in our approach. Generally, I think our constituents are better served if we follow a narrow definition of what constitutes a ‘single subject.” To the average taxpayer, combining more than one issue into a single piece of legislation seems inappropriate and contrary to what they expect of their elected officials.
The original legislation, Public Act 96-34, dealt not only with construction projects, but with spending rules, new taxes and fees, privatizing the Illinois Lottery and other issues. Additional and related legislation, which hinged on the passage of Public Act 96-34, also contained a host of topics including economic development, rental car provisions and even an urban weatherization program.
Regardless of how the Supreme Court rules, we could avoid these problems in the future simply by adopting strict rules about mixing subjects in legislation. This is not the first time that the courts have raised the "single-subject"question and unless we reform ourselves, it’s unlikely to be the last.
But, that’s not the real concern. My biggest concern is the perception it creates with the public when a mish-mash of topics get lumped in together. The public is justifiably skeptical of Illinois government, especially given the events of the past decade. We need to go beyond the minimal requirements of the law in order to restore the public’s trust in state government.
MEDICAID REFORMS NOW LAW
Significant reforms to the state’s Medicaid program, including many that had long been sought by Republican lawmakers, were signed into law during the week.
On January 25, long-awaited Medicaid reform legislation (House Bill 5420/P.A. 96-1501) was signed into law. The new law is a good first step toward establishing greater control of the Medicaid program, while also advancing limitations to rein in the burdensome cost of the program and ensure health care providers are paid for their services more promptly.
The legislation was the result of bipartisan negotiations spurred by the Special Senate Committee on Medicaid Reform, which was charged with examining the state’s Medicaid program and identifying ways to reduce program costs by creating efficiencies and targeting fraud. Health care advocates, medical providers and state agency representatives offered insight into ways to streamline services and reduce waste, which became the framework for House Bill 5420.
Medicaid reform has been discussed for years, prompted by the unsustainable growth and associated costs of the program. Over the last 10 years, enrollees have almost doubled, and the program regularly grows at rates of between 5 percent and 10 percent annually. With an all-time high of 2.8 million Illinois residents enrolled in Medicaid, the cost of the program is absorbing more state revenues than even education.
Senate Republicans have been long-time advocates for Medicaid reform. This new law is a positive step toward restructuring Illinois’ health care program for the poor and disabled, and more can be done The system is still fraught with waste and greater efforts must be made to target exploitation and abuse within the Medicaid program.
Utilization of managed care principles will increase dramatically over the next four years under this legislation. Ultimately, 50 percent of all people will be required to be in a system of care coordination, or managed care, which will provide for better care for the enrollees and save taxpayers’ money over time.
The measure will also phase out the “Section 25” loophole that has allowed the state to pay Medicaid providers late. Over the years, this loophole has enabled Illinois government to defer payments to doctors, pharmacists, hospitals and nursing homes while portraying deficit spending as “balanced.” House Bill 5420 will ultimately eliminate the ability of state government to do that.
One of the most important components of the bill is a two-year moratorium on any new or expanded Medicaid programs. The new law also establishes stricter eligibility requirements to ensure more accurate reporting of the applicants’ true income.
It also puts in place a more active redetermination process. The Department of Healthcare and Family Services over the last several years had simply send a letter out asking if a recipient’s circumstances had changed. Even if Healthcare and Family Services didn’t receive a response, the patient was left on the program. That practice is going to come to an end, replaced by a more aggressive redetermination process.
Another key provision of the bill will impose reasonable income restrictions on the state’s “All Kids” programs, which previously did not contain any income limits. An auditor general review last year found that even at the highest income levels, which could exceed $100,000, taxpayer dollars were subsidizing health insurance costs.