Bill on hospital-care discounts may be scuttled by Gov. Rod Blagojevich's amendatory veto Governor's changes too expensive, hospital group says
September 11, 2008
Judith Graham
Sep. 12, 2008 (McClatchy-Tribune Regional News delivered by Newstex) -- Illinoisans without health insurance were poised to get substantial price breaks on hospital care under groundbreaking legislation passed this spring. But now, that deal could be falling apart.
The cause: a recent amendatory veto by Gov. Rod Blagojevich.
The bill, passed unanimously in the House and the Senate, would have guaranteed uninsured Illinois consumers the most generous hospital discounts in the U.S. and capped what they spend annually on hospital care. More than 775,000 families in the state would have qualified financially for assistance, according to one estimate.
But that didn't satisfy Blagojevich, who expanded the scope of the legislation to cover patients at higher income levels and deepen the discounts offered.
The move angered sponsors in both houses. "I'll be filing the necessary motion to override the governor's veto at the first available opportunity," said Sen. Jeffrey Schoenberg (D-Evanston), who sponsored the measure.
It also upset the politically powerful Illinois Hospital Association, which had opposed the legislation but changed its position after extensive negotiations with the Illinois attorney general's office. Under Atty. Gen. Lisa Madigan, the office has been moving to ensure that hospitals deliver charitable benefits to their communities and abide by fair billing practices.
The association contends that Blagojevich's revisions would place hospitals in financial jeopardy by requiring them to offer steep discounts to almost everyone without health insurance in Illinois. One consequence may be that middle-class families won't buy insurance even when they can, figuring they'll be able to afford hospital bills.
"This is an issue that the legislature, the attorney general, unions and the hospital association worked on for over a year," said Howard Peters, the hospital association's senior vice president of government relations. "There were numerous hearings in Springfield. The governor's office and state agencies didn't so much as offer an opinion or participate in a single hearing--and now they do this."
Asked to comment, the governor's press office issued a statement: "With these improvements, additional low-income Illinoisans and uninsured middle-income families will have the ability to receive essential medical services."
The Blagojevich administration did not inform the attorney general's office of plans to alter the legislation, said Paul Gaynor, chief of the office's public interest division. The hospital association received a courtesy call the day of the amendatory veto, as did the sponsors. "I was shocked," said Rep. Karen May (D-Highland Park), the sponsor in the House.
Illinois hospitals had agreed to charge most patients without insurance what it actually costs to provide care plus a markup of 35 percent. Uninsured patients currently pay two to three times the actual cost of care.
The governor cut the markup to 20 percent above cost and specified that patients earning less than 200 percent of the poverty level--$42,400 for a family of four--wouldn't pay any markup.
Urban families earning up to 600 percent of the federal poverty level--$127,200 for a family of four--were to qualify for hospital discounts and the annual spending cap. The governor raised it to 800 percent, or $169,600. For rural families, the governor raised the eligibility level from 300 percent--$63,600 for a family of four--to 600 percent.
The biggest surprise in the governor's amended plan is an entirely new provision requiring hospitals to provide 50 percent discounts on out-of-pocket costs for insured children with diabetes.
May alleged that Blagojevich was seeking to curry favor with House minority leader Tom Cross of Oswego and make it hard for the Republicans to vote for an override. Cross has a diabetic child.
In its statement, the governor's office said the diabetes discounts were "part of the governor's continuing effort to expand access to health care."
Blagojevich also gave the power to enforce the legislation to the Illinois Department of Public Health instead of the attorney general's office, a move that "totally eliminates any meaningful enforcement capability," Schoenberg said.
If the House and the Senate fail to endorse the governor's plan by a simple majority, it dies. Overriding his veto would require a three-fifths supermajority in both chambers.
May said she'll reintroduce the legislation again next year, if necessary. "I would never give up on an issue that's so important," she said.
jegraham@tribune.com
