Hundreds of thousands of people would see their healthcare cut back or even eliminated under legislation approved Thursday by Illinois lawmakers in a desperate attempt to shore up the state's crumbling budget.
The Medicaid cuts include ending a prescription drug program for senior citizens, halting two programs that provide health insurance for about 35,000 people, and restricting access to services from heart bypass operations to wheelchair repairs.
Opponents said the cuts will mean suffering and death for some of the 2.7 million people who get care under Medicaid.
"I'm begging you, representative, for the life of the people who are going to die as a result of this legislation. I'm begging you. Please, let us do something different," Rep. Mary Flowers, D-Chicago, said to the measure's sponsor.
Rep. Sara Feigenholtz, D-Chicago, said the Medicaid program will fall apart without fast action. Helping the state's poor in the long run requires cutting back now, she said.
"I know it seems ironic, but this is the only way we can accomplish that," Feigenholtz said.
The measure passed 94-22 and went to the Senate, where it was approved on a 44-13 vote. The next stop is Gov. Pat Quinn, who supports the proposal.
It's part of a package meant to fill a Medicaid shortfall of $2.7 billion, or nearly $1 in every $5 the program spends.
Service cuts would save about $1.3 billion. Payments to hospitals, nursing homes and other Medicaid providers would be trimmed by an additional $240 million. In a separate bill, lawmakers will consider more than doubling the state cigarette tax to bring in more money.
Republican opposition has left the outcome of the tax vote in doubt.
But House Minority Leader Tom Cross, R-Oswego, said Thursday evening that the depth of Medicaid cuts had convinced some of his colleagues to agree to the cigarette tax increase. "I think you'll see a complete package pass," Cross said.
Sen. Dale Righter, a leader on Medicaid issues for Senate Republicans, said he doubted any of his GOP colleagues would support the tax increase. If the tax doesn't pass, Democrats would be forced to return to the bargaining table to consider more spending cuts, he said.
The package addresses one of the two huge problems facing state officials during the spring legislative session. The other, controlling the rising cost of government pensions, is still the subject of intense negotiations and pressures.
House Speaker Michael Madigan, D-Chicago, said Thursday that he won't go along with a proposal to cut pension costs by raising the retirement age to 67. He told The Associated Press that the change would violate the Illinois Constitution's ban on lowering pension benefits that have already been promised.
Madigan said he wants to move forward with requiring downstate and suburban school districts to pay the pension costs of their teachers instead of leaving that expense to the state. He said he wants to phase in that change.
Illinois Medicaid costs have climbed dramatically, thanks to increasing demand in a rough economy and to rising health costs in general. The state is months behind on paying the doctors, hospitals and nursing homes that provide care under Medicaid, and the program takes up scarce dollars that could be used for other important services, like education or public safety.
In February, Democratic Gov. Pat Quinn called for legislators to fill a $2.7 billion shortfall or face the possibility that the program would collapse entirely. Quinn applauded the General Assembly for Thursday's actions.
"This is the first step toward saving Medicaid for those that rely upon it," Quinn said in a statement that also urged quick action on raising the cigarette tax.
The Medicaid legislation would eliminate Illinois Cares Rx, a program that helps nearly 200,000 seniors pay for prescription drugs, to save about $72 million.
"If they cut it out, it's going to hurt a lot of us seniors. If we can't get the medications, we die," said retired Evanston resident Martha McDonald, who takes five prescription medications and pays less than $15 a month for them because of the program. "They're helping these young girls having babies, why not the seniors?"
Medicaid pays for more than half the childbirths in Illinois and nearly 94 percent of births to teenage mothers.
The plan includes new efforts to weed out people in the program who don't meet the proper guidelines. That is supposed to save $350 million.
The bill includes changes as small as saving $150,000 by giving nursing home residents only seven days' worth of medicine at a time, instead of 30 days' worth. The reason? Longer prescriptions mean more medicine goes to waste when residents die.
Medicaid clients would also be required to get prior approval for all wheelchair repairs, which is supposed to save $800,000.
Another provision sets a limit of four on the number of prescriptions Medicaid will cover unless recipients get special permission. It's supposed to save $180 million a year.
The change worries Jessica Patrick, who now takes three medications for epileptic seizures, bipolar disorder and heartburn. She spent 15 years living in a nursing home and said the medications, properly managed, allow her to live on her own in an apartment.
"Medicaid isn't paying for the things we need to keep us healthy," said Patrick, a 32-year-old Chicago resident.
Both legislative chambers also approved a measure that will let Cook County collect federal matching funds for medical care it already provides to 100,000 low-income people. The legislation doesn't increase state costs, but some Republicans were opposed because it involved early adoption of a provision of President Barack Obama's new federal healthcare law.