(bright music) (bright dramatic music) - Welcome to "Capital View" on WSIU.

I'm Jeff Williams sitting in this week as we take a look at what is making news around the state in Illinois politics.

And to help guide our discussion are Peter Hancock, a State House reporter for Capitol News Illinois, and Kent Redfield, Emeritus Political Science Professor at the University of Illinois Springfield.

Gentlemen, welcome back.

- Good to be here.

- Thanks.

- Thanks, thanks.

Well, as we're getting down, it is kind of crunch time on the spring legislative session.

There is certainly a lot going on, but I wanted to start this week with an administrative hearing that was held yesterday as we taped this program regarding the governor's plan to basically shut down a program that has been providing publicly funded healthcare coverage to non-US citizens in the state, many who are also in the country without legal authorization.

Peter, I know you've been following this story, what's the latest?

- Well, the Department of Healthcare and Family Services, which is the agency that administers Medicaid, as well as a number of other healthcare programs, has been told to shut the program down starting July 1st, which is the first day of the new year.

This was part of Governor Pritzker's budget plan for the upcoming fiscal year.

The state is facing kind of flattening revenues and he needed to fill a pretty large budget hole.

And so this was one of the things to save a couple hundred million dollars.

So the department has promulgated what you call administrative rules, which call for shutting the program down.

These rules have to go before a kind of obscure legislative committee called JCAR, the Joint Committee on Administrative Rules, and this committee, it's split half and half between Democrats and Republicans, half and half between House and Senate.

It exists to make sure that any rules or regulations that state agencies adopt are consistent with legislative intent.

And so these rules came up on the agenda and basically the committee just passed over them.

They took no action one way or the other, which means that they remain in place, but they also kind of remain on JCAR's agenda for next month when they could do something.

But essentially, it means that the program is still on track to be shut down at the end of June.

The coverage that people have under this program, which is a little more than 30,000 immigrants between the ages of 42 and 64, people who would qualify for Medicaid, but for their immigration status, their coverage will end on June 30th.

- So Peter, I think something else that, I believe it's an ongoing study by the University of Chicago, and I think it's maybe something else that you had reported on, indicated that healthcare facilities and hospitals and whatnot around the state benefited from having this plan in place.

- Yeah, and this is I think what you would find with sort of any publicly funded health coverage program that ensures people who otherwise can't be insured, it reduces the amount of uncompensated care that hospitals have to give out.

You know, a lot of hospitals are required by various laws to treat anybody who walks through the door, especially nonprofit hospitals, charitable hospitals, community hospitals, things of that sort.

And so many of them carry a large amount of what they call bad debt or uncollectible debt on their books because of people who have no kinds of coverage.

When the Affordable Care Act came into effect in 2010, 2011, it had the same sort of effect.

It drops the amount of uncompensated care that hospitals have to give out.

This, likewise, people who are not citizens, they're not covered by Medicare or Medicaid, they're not covered by private insurance.

They get sick, they go to the emergency room to get treated, and there's no money to pay the bill.

The hospitals just end up kind of eating that cost.

This program did in fact, according to preliminary data, and I should say that the study is still going on, they're still analyzing a lot of data, but they looked at the amount of uncompensated care given out in Illinois hospitals, compared it to Indiana and Wisconsin, two neighboring states that don't have this immigrant healthcare program as kind of control groups.

And what they found was about a 15% reduction on average across all hospitals in the amount of uncompensated care they were giving out.

- Kent, you- - And- - Yeah, go ahead, Kent.

- Yeah, this is in, you know, spending that we took on last year that was not planned in response for the waves of buses that came, I think primarily from Texas, with immigrants and were dumped in, primarily in Chicago, but other places in Illinois.

So this was an additional spending.

We were still in, you know, fragile but not unreasonable budget shape a year ago.

But we are now in really bad fiscal shape.

And so this is essentially taking it out of the base.

And there's another part of this where we extended healthcare to undocumented immigrants that were seniors, and that turned out to be much more expensive than the estimates that were initially put forward.

And so this spending puts a lot of pressure on the budget, and now we are finding that with the money from COVID, the residual spending money, that we have spent that down and it just becomes daily bad news.

So I believe yesterday we reduced the governor's office of management budget, reduced their revenue estimates by some, you know, more than $500 million.

And then we also, preliminary estimates seem to indicate that we are spending more money than, at a higher rate, than we had projected.

And so this becomes a very fragile budget situation with not a lot of good choices.

When the governor made his budget address, he said, "Well, I'd like to go forward with the early child education, but we're gonna have to hold that, you know, steady because we can't, we don't know what the budget's gonna look like."

And what he was talking about that time looks absolutely rosy compared to the situation that we're in now.

And so there are a lot of hard choices and there could be further damage from the federal government, not only in terms of withholding spending, but administrative decisions or things that become the force of law through reconciliation, changing the formula for reimbursing Medicaid.

That isn't a cut in the sense that, you know, it changes reimbursement and we have a mandate to provide the services, unless we back out of it.

And so, there can just be an awful lot of bad news that is gonna be very hard to make accurate predictions between now and the supposed, you know, end of the session as far as the budget is concerned, which is the end of May.

At that point, it takes more votes to get an immediate effective date, it's not like the world ends, but it's easier to do business if you can reach agreements and only need to put 60 and 30 on it.

You know, the Senate, or I'm sorry, the Speaker of the House and the governor have both hinted about, well, maybe we're in for coming back and redoing things in the fall, which is the last thing the legislature wants to do when you're starting to pass petitions and thinking about the March primary in 2026.

So this is not the, you know, this is a huge change from the way we've been budgeting over the last six years or so, post-Rauner.

- Sure.

I wanted to ask you, you mentioned specifically on this particular initiative, I think the Auditor General's report indicated that it's gonna cost about $1.6 billion, give or take, which obviously more than what was the original estimate on that.

In terms of decision, and granted, there's a lot of, there's a lot of different budget considerations that go into this in terms of the, like you say, the Medicaid funding at the federal level and the state funding that the state's responsible for when we're talking about this particular program, and given the state of the budget we've talked about, is this low hanging fruit, is this an easy decision for the governor and for the general assembly in terms of, or maybe I should say Democrats in terms of coming up with a budget?

- It is not easy when a big part of your political base consists of Latino lawmakers, the Latino community throughout Illinois, and people especially on the progressive wing of the Democratic party, who are strong advocates for immigrant rights, who think that, argue that these people should be taken care of humanely and that they should have access to healthcare.

They would argue that these people do contribute to our economy and to our society, and they should be treated as humanely as any citizen of the United States.

And the fact that, you know, obtaining citizenship and obtaining legal permission to be in the United States is a much more complicated and byzantine process than some people think it needs to be.

So when that's a big part of your political base, yeah, this is a hard decision to make.

Nonetheless, yet from a budgetary standpoint, and especially if you look at, you know, sort of the political mood of the country right now, the mood of Washington right now, it's probably easier to let these programs go than to try and fight to keep them.

Of course, it's no secret that Governor Pritzker is eyeing a possible national race in 2028 if he hasn't already made up his mind.

And national polling would show that giving taxpayer funded healthcare to non-citizens who are not legally authorized to be in the country is maybe not the most popular thing to be doing right now.

So from that perspective, yeah, it's low hanging fruit.

There was that audit that you mentioned that said over the, you know, since the programs began, the two things combined through I think fiscal year 2024 had cost about $1.6 billion, which was far more than anybody had expected, that the audit also found that there were people being enrolled in these programs who didn't necessarily qualify, people who could have gotten regular Medicaid because they had been in the country long enough to qualify for Medicaid.

There've been a lot of administrative issues with this, as there would be with any kind of large healthcare program, there are gonna be administrative issues.

So, I don't think it's easy within Illinois politics to do this because there is a lot of resentment among the Latino caucus and various other progressive segments within the Democratic caucus in Illinois who are not real excited about letting this go.

- I wanna- - Go ahead.

- No, no, go ahead, Kent.

- No, and it isn't, you know, this is a change in kind of the rhythm, the way that we've been making decisions because we haven't had to make a lot of trade-offs and a lot of tough votes.

And so this may be the first of a number of tough votes, tough decisions, and we're gonna have to, you know, if it's as fragile as it looks, we're gonna have to tell a lot of people no.

And we are certainly not used to dealing with, you know, an austerity kind of situation.

And again, not knowing what actual number you're working with, you know, how much money can we expect?

What kind of spending pressures and entitlement pressures might be visited on us from the federal government?

Makes planning very difficult.

I mean, you don't wanna make a lot of tough cuts and then have a lot of money left over.

On the other hand, the governor said, "Well, we're still gonna put money in that rainy day fund.

And as somebody commented, "Well, the storm clouds may be gathering."

And so, having saying that, you know, we can still plan for the future, the future may be now in terms of trying to get through this budget cycle.

- Yeah.

As we look at this budget cycle, and obviously it's gonna be difficult this year, where does this fall kind of on the continuum, if we're comparing this budget to previous years?

Is this like what we experienced during the Rauner administration?

I think many of us in most state agencies remember what that was like, or is this a process more like what we went through under the Blagojevich or the Quinn administrations or is this more a Thompson, Edgar kind of budget situation?

Or do we have anything to kind of compare where we are this year in terms of the budget?

- I think in the broad scheme of things, what we're facing now is kind of normal.

I mean, state budgets and the economy go through a cyclical crisis, or cyclical process.

There are good times and there are lean times.

We're going through a little bit of a lean time, when revenues are flattening and there are increasing demands on the state budget, including the automatic increases in pension contributions, the automatic increases in K through 12 spending, lot of other built in kinds of cost increases.

When your revenues flatten out, then you start coming under pressure.

I think one of the unique things we have right now in Illinois is that there are a lot of legislators elected in 2018, and subsequent to that, who've never really been through a lean time before.

I mean, they've had it pretty easy for most of the Pritzker administration.

The revenues have been coming in fairly strong.

Pritzker has done a pretty good job, did a fairly good job in his first year, of getting rid of a lot of low hanging fruit and making some efficiency improvements along the way.

But there are a lot of lawmakers who've, you know, as Kent was saying, they've never had to say no before, and now all of a sudden, they're gonna have to say no to a lot of requests and that's not something that politicians naturally want to do.

And so that makes it politically a little more difficult.

- Yeah, yeah, sure.

- Kent, I wanted to, one thing I wanted to bring in, and you can work this in there, I know that Chicago Mayor Johnson made a trip down to Springfield, I dunno if it's been, a couple of weeks ago, as the Chicago mayor apt to do during the legislative session.

What does the outlook look?

I mean, you've got the Northeast Illinois transit system, you've got funding for the city of Chicago for both schools and for the city.

Are those still kind of elephants in the room for this budget year?

Or are there going to be some movement maybe in that area?

- I, the Chicago school system, you know, they've got a contract and whether or not that is a disaster waiting to happen as they implement it, it's too early to tell for that.

The transit situation, you've got to make structural changes with different empires, agencies, fiefdoms, whatever you wanna call them, that you're all trying to coordinate and it's a very chaotic management situation.

And then the decrease in federal funding, I mean, there's a fiscal side and a policy side and they need a grand bargain and they need some revenue.

And I don't figure any way to deal with that before the end of, you know, before they leave town.

And you know, we used to, I mean, if you're gonna go back into the time tunnel, it used to be, a Republican governor with a democratic legislature with a competitive Republican minority and the mayor of Chicago was a huge factor.

And now, you had great diminishment of the role of the city of Chicago, the influence of the city of Chicago, and the same thing true with Republican, the Republican party in general, or the Republican Party within the House.

And so, you know, the good news is the Democrats own and control the whole thing, but that's also the bad news in terms of, there's nobody to blame if this, you know, if this all falls apart.

So it is, you know, different eras, different dynamics, and you know, this would not be, Mayor Daley would not recognize this environment and old style legislators used to, you know, horse trading back and forth on the budget would not recognize this environment.

- Yeah, so probably no money for the Bears in this fiscal year?

(group chuckles) - No.

- No.

Okay.

Okay.

Right.

I wanted to, we talked about the governor, we mentioned it earlier about the governor, and he's been on the national stage acting more or less kind of presidential, or at least presidential in the sense of going into, going into an election or into an election year.

He's gonna be taking part in a congressional hearing, I believe, next month as well.

He's continuing to kind of raise his national profile.

So do we, what do we think, is he going to be running for president?

What does this say about a potential third term for governor?

And I guess maybe the important underlying question is, what impact is all of this having on current governance?

- Well, I can take a crack at that.

We're expecting to hear soon whether or not he's gonna run for a third term as governor, 'cause as Kent mentioned earlier, the season for circulating petitions is coming right around the corner.

So he's gonna have to make a decision about whether he runs for a third term or sits out for two years to organize a presidential campaign to run in 2028.

The problem with sitting out for two years is that you drop out of the news, you drop out of people's line of sight, and it's easy to be forgotten.

Whereas, you know, other people are more active and can stay in the headlines and keep generating public interest.

So he's got a lot of things to weigh right there.

How much that's weighing into, you know, state politics right now, you also have to realize we've got a lot of other things going on, with Dick Durbin stepping down and now Jan Schakowsky stepping down, you have members of Congress who, the US House who wanna run for the Senate.

You've got members of the legislature who wanna run for the US House.

There's this sort of trickle down effect that this has, cascading effect of people wanting to move up the ladder.

And then in the middle of that, you've got Governor Pritzker who hasn't apparently made a public decision about whether or not he's going to run for a third term or step back and organize a national campaign.

So yeah, everything is very fluid right now.

- Yeah, I would be, I guess I'm gonna be surprised if he doesn't run for president.

I think the big question is whether he also runs for reelection first, but he, you know, every opportunity that comes up, we had a mild rumbling at the national level about Health and Human Services collecting data and somebody mentioned a registry of autistic, you know, people with autism, and then Pritzker gets headlines nationally for the first state to have an executive order barring state agencies from participating in any kind of collection, which I really don't think Health and Human Services was really going to do that.

But they're not very good at articulating exactly how you do science.

And that tends to cause a lot of confusion, you know, and the governor got a back and forth with the Secretary of Homeland Security when she was in town on Wednesday, you know, talking about bad the state was for dealing with immigration issues.

And then, you know, ended up with an unfortunate situation where she was out holding a press conference in front of, you know, in close to the home of a woman who was killed in a domestic violence situation, I believe, with an undocumented alien a couple of years ago.

But the parents of this woman were down at where the initial press conference was supposed to be held, down at the Governor's Mansion, protesting against the Secretary of Human Services.

And she's using this woman's case as kind of, you know, prime example of how bad Illinois is and that provided the governor with another opportunity to make a statement and get lots of national coverage.

So it's a distraction.

I think it's, you know, and we've also got the people that would like to run for governor are really encouraging the governor to run for president and talking about how much easier it would be if he didn't have to worry about running the State.

So, it's just, you know, one more, this great game of musical chairs that we're in with, you know, is likely to continue.

- Well, as the saying goes, we're certainly living in interesting times.

So Peter and Kent, thank you very much for joining us this week on "Capitol View."

Peter Hancock, State House reporter for Capitol News Illinois, and Kent Redfield, Emeritus Political Science Professor from the University of Illinois Springfield.

I'm Jeff Williams.

Thank you all at home for joining us this week on "Capitol View."

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