What Happened in Springfield Last Week??
A State Budget, Sort of

Posted on June 4, 2010 by Dan Lesser

The General Assembly stands adjourned, for now, as legislators took the half-baked state budget pie out of the oven before it could finish cooking so they could rush off to appear at the Memorial Day weekend parades. 

Heading the list of unfinished business is the failure to provide for paying off the state’s $3.7 billion fiscal year 2011 pension obligation. The Governor had sought authority to borrow these funds, as Illinois did last year, but the General Assembly declined his request. 

Since borrowing authorization requires a 3/5 majority, at least one Republican vote was needed in the House. Two retiring Republicans voted in favor and one Democrat voted against, so the pension borrowing measure cleared the House by the narrowest of margins. In the Senate, however, where no Republican votes were needed (and none were forthcoming), two Democrats blocked approval of the pension borrowing authority on the grounds that it would simply aggravate our fiscal problems without being part of a plan, including a revenue increase, to actually solve our fiscal mess.

So where does the General Assembly’s decision not to approve borrowing authority to cover the FY11 pension obligation leave us? The budget approved by the General Assembly assumes that $6 billion in outstanding bills will be unpaid at the end of FY11. If FY11’s pension payment cannot be borrowed, then another $3.7 billion must be added to the $6 billion in unpaid bills that the budget is predicated on, making the grant total of unpaid bills at the end of FY11 $9.7 billion. Or, the pension funds could cannibalize themselves, selling off investments to meet current obligations and thus dramatically lowering future investment income. Given these unpalatable options, the Senate’s leadership may continue trying to find the one vote needed to approve borrowing $3.7 billion to cover the FY11 pension payment.

The fiscal year 2011 budget passed by the General Assembly (H.B. 859) resembles last year’s. Rather than making line-by-line appropriations as in the past, and as the Governor had proposed, the General Assembly continued last year’s practice of providing lump-sums to the agencies and leaving it to the Governor to decide which programs to fund and which programs to cut. The overall amount appropriated for grants remained about the same as last year but the appropriation for state operations was cut by 5 percent. The Governor was again given $3.2 billion in unallocated funds to spread around as he sees fit. Different state agencies fared differently – the Illinois Department of Human Services, for example, was appropriated only $2.5 billion, $1.5 billion less than its current appropriation of $4 billion, although the Governor can use the $3.2 billion in unallocated funds to cover some or all of this gap.

The General Assembly also passed an Emergency Budget Act, which gives the Governor sweeping powers to make cuts without legislative review (S.B. 3660, House Amdt. 9). It allows him to put more than $2 billion into a contingency reserve that could not be spent by the agencies. It also makes all state programs, whether authorized or required by state law, “subject to appropriation,” i.e., not operational unless supported by an appropriation that is not otherwise obligated or reserved. These emergency powers expire on January 9, 2011, at the end of Governor Quinn’s term.

While abdicating responsibility for making unpopular budget cuts, the General Assembly again avoided consideration of the only viable alternative for solving our budget mess – raising revenue, as the Responsible Budget Coalition has advocated, along the lines of House Bill 174, which would increase the individual income tax rate from 3 to 5 percent and broaden the sales tax base to include services, raising approximately $6 billion in annual revenues. The General Assembly also chose not to capture $320 million in annual revenue from a proposed cigarette tax increase. The General Assembly did approve a tax amnesty plan whereby tax cheats can pay off their debts without penalty, which is estimated to raise $250 million (S.B. 377, H. Amdt. 3). The legislators threw $50 million of this back by approving a “sales tax holiday” for back-to-school purchases in August.

The budget also relies on various one-time revenue sources, including $1.2 billion obtained by borrowing against the proceeds from the remaining 17 years of a tobacco settlement fund.

As the Illinois General Assembly was wrapping up last week, word came that the U.S. House of Representatives had stripped the enhanced Federal Medical Assistance Percentage (FMAP) six-month extension from the unemployment insurance extension package, considered the best vehicle for its enactment. Unless restored by the Senate and agreed to by the House-Senate conferees, or included in a different legislative package, this continuation of ARRA federal fiscal relief to the states will come to an end, blowing another $700 million hole in the FY11 state budget.

In sum, regardless of whether borrowing to pay this year’s pension tab is approved, the state will continue to lack the revenues to pay its bills. By the time this fiscal year comes to a close at the end of June, Illinois will have racked up $6 billion in unpaid bills. The budget proposed by the Governor and approved by the General Assembly assumes there will still be $6 billion in unpaid bills at the end of the next fiscal year in June 2011. Nobody believes that this number will not grow. While the Governor will make some visible cuts to programs, far more insidious and lethal will be the state’s continuing and expanding practice of not paying its bills. State-funded providers of services to young children, the elderly and disabled, the homebound, the developmentally disabled, the mentally ill, those addicted to alcohol and controlled substances and so on will not have the plug pulled on them all at once. Rather, they will die a slow and agonizing death as month by month the state’s payment for services rendered does not arrive and, one by one, they are forced to give up the ghost.   

List of Enacted State Budget-Related Legislation:

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Medicaid Savings: Good Idea, But Illinoisans Missing the Main Opportunity

Posted on June 17, 2009 by John Bouman

States across the country are wrestling with budget crises.  In that context attention always turns to Medicaid, just because it is a large budget line, and it is therefore an attractive mark for anti-tax advocates who do not really have viable alternatives to taxes but like to speak vaguely about cutting spending.  The Illinois budget mess offers a lesson in why these folks have the germ of a good idea but are missing the most promising way to achieve it.

Most knowledgeable people concede that there is no way out of the huge Illinois budget deficit but to raise revenues.  Of course, many of those same people do not support raising the necessary revenues.  The opponents disingenuously cry out that Illinois must never increase revenues until it has made “cuts” to the spending side.  Tellingly, they have been unwilling or unable to specify exactly where they would cut the billions needed to balance the budget without increased revenues.  Accountability is not their strong suit.

But there is nevertheless an interesting modest overlap between this “cuts” position of the opponents of revenue increases, and the position of the proponents. Led by the Governor, the proponents are committed to making reductions in state spending, as part of the overall budget package that includes the revenue increases.  Greater efficiency is always a good and desired goal, and it is even more important in such difficult times. Moreover, revenue increases are more palatable, more fair, if state government is making efficiency improvements at the same time.  

So both sides are focusing on ideas for cuts.  One of the centers of attention for this kind of brainstorming is all of the state’s publicly supported health care coverages, popularly lumped together under the term “Medicaid”.  The programs cover children, low income working parents, people with disabilities, and the elderly. The opponents of revenues, citing old and sloppily done consultants’ reports, say that Illinois could be saving $1 billion or more on Medicaid, mostly by imposing hardcore HMO-style managed care, insisting that people use generic instead of costly brand name drugs, and caring for more people in the community instead of nursing homes. The proponents of revenues, citing actual experience in Illinois that shows the state is already realizing significant savings from care management, generic drugs, and community based care, say that they are willing to try any reasonable new ideas, but estimate savings in the tens of millions. The fact is that Illinois is already among the lowest in per person Medicaid expenditures.

Both sides are missing the most likely source of significant Medicaid savings that will neither limit coverage nor impair care. It is not a Springfield initiative, but a Washington DC initiative that will get this done. As should be obvious, Medicaid is just one part of the larger health care system, most of which is in the private sector. Medicaid suffers from the same system-wide phenomena that are driving the dizzying upward spiral of health care costs for all of us – profiteering across the board, inefficiencies, lack of focus on prevention, loss of consumer choice and control, and so forth. It is this increase in cost, decrease in control, and loss of peace of mind that is driving the anger in the American people that in turn is driving the move towards comprehensive reform being led by President Obama. 

These problems in the larger health care system fuel the trend in Medicaid spending. Thankfully, every year Medicaid spending (known as Medicaid “liabilities”) grows at a rate that is smaller than the overall consumer price index for medical related goods and services. Medicaid is a more efficient system. Yet Medicaid costs are necessarily directly related to the larger health system market. When health care costs go up generally, they also go up for Medicaid.

All those folks in Springfield looking for ways to spend less on Medicaid should realize that they are looking in the wrong town. The action on this is in Washington, where the battle over comprehensive reform is playing out right now. Just a couple of days ago, President Obama asked Congress to produce ideas for overall health system reforms to bring down the cost of care, or at least the rate of growth of the cost of care. He noted that in so doing, they would also be helping to produce $200-300 billion in savings for Medicare and Medicaid. 

For those truly interested in controlling the growth in Medicaid spending, the most promising course is to help make sure that the drive for national comprehensive health care reform is successful this year.  Meanwhile, the Springfield folks should tend to the knitting and vote for the revenues needed to fund state government.

 

 

 

 

 

 
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