CHICAGO (AP) — Illinois moved closer to drastic Medicaid cuts Monday with proposed legislation that could excise nearly $1.4 billion from the state's program by shrinking benefits, such as regular adult dental care, and cutting payments to most hospitals and nursing homes.

The measure, backed by Gov. Pat Quinn, falls short of the $2.7 billion in cuts that Quinn originally said would be needed to prevent the health care program for the poor and disabled from collapsing.

Legislative sponsors said revenues, including Quinn's proposed $1 cigarette tax increase, will be dealt with separately, and are needed to make the plan work.

"I honestly believe it is just not doable" without the cigarette tax, said Sen. Heather Steans, a Democrat who served on a four-member bipartisan Medicaid committee.

The measure, filed as a House amendment to a Senate bill, includes $240 million in payment rate cuts to hospitals and nursing homes. But it spares doctors from rate cuts, along with 51 rural community hospitals and about 20 urban hospitals that care for poor patients.

The legislation eliminates most dental care for adults, but keeps emergency dental care. It limits adult eyeglasses to one pair every two years, pays the same amount for cesarean sections as for vaginal deliveries — unless the C-section is medically necessary — and limits podiatry care to people with diabetes.

The bill would eliminate Illinois Cares Rx, a program that helps nearly 200,000 seniors get prescription drugs, which concerns the AARP.

"Not only are they trying to balance the budget on the backs of Illinois seniors, but cutting Illinois Cares Rx will not help balance the budget," said David Vinkler of AARP, who added that seniors will end up going to the hospital and nursing homes more often when they can't afford their medications.

Medicaid payments to many hospitals would be cut by 3.5 percent, but the bill exempts rural community hospitals and safety-net hospitals from the cuts. Association of Safety-Net Hospitals spokeswoman Julie Sznewajs said Latino and black caucus members are "standing strong for their communities" by supporting the exception.

"Lawmakers are hearing loud and clear that safety-net hospitals play a critical role in treating the poor and underserved," Sznewajs said. A spokesman said the Illinois Hospital Association also is still evaluating the bill.

Democratic Rep. Sara Feigenholtz, a sponsor of the legislation and a Medicaid work group member, said she expects a vote in the House on Wednesday or Thursday. She said she hopes some Republicans can support the approach.

"There's been a great deal of goodwill built up on this long camping trip," said Feigenholtz said, referring to the negotiations that led to the measure, including the work of the bipartisan Medicaid committee. "I don't want to speak for (Republicans), but I'm optimistic."

Republican Sen. Dale Righter, who serves on the Medicaid committee, had some kind words for the legislation, but said he was not quite ready to call it bipartisan. Righter said he likes the section that — as he puts it — "cuts up the state's Medicaid credit card."

Illinois has been able to delay Medicaid payments by pushing them into the next fiscal year, but the bill would phase that out, something Righter called an "important long-term reform."

At a Monday press conference in Springfield, Quinn said the next 10 days are "crucial, really, for not just today but for our kids."

"We must restructure our Medicaid system to prevent collapse and we must reform our pension system so we don't have an ocean of liability that confounds Illinois for years to come," Quinn said.

The governor dismissed questions about gambling expansion, saying he won't let himself be distracted from more important issues and hopes lawmakers won't either.

"Sometimes down here, shiny objects can distract people. We don't want any of that," Quinn said. "My job as governor is to keep my eye on the ball and to try to keep all the legislators' eye on the ball."

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Illinois Medicaid bill makes nearly $1.4B in cuts

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