Seth Perlman, File, Associated Press
SPRINGFIELD, Ill. — Gov. Pat Quinn is about to deliver his fourth and perhaps most anticipated budget proposal. He already has cut spending and raised taxes, yet Illinois remains in dire financial shape, in large part because of ballooning health and pension costs.
When Quinn delivers his budget speech Wednesday, he'll face big questions about where to go next — questions that could affect local schools, towns scattered across Illinois, retirement security for tens of thousands of people and health care for millions. In recent days, he or his office have spoken about cuts to Medicaid and constitutional officers' budgets and closing state facilities.
Here are five key questions he'll face:
HOW MANY STATE FACILITIES COULD BE CLOSED?(equals)
Quinn told The Associated Press last week that his budget will call for closing "quite a few" state facilities. He told WBEZ radio that those facilities will include youth prisons. Illinois has eight, scattered from Chicago to deep southern Illinois.
"You have to make some sound decisions. I have," Quinn told the station. "I have the courage to back 'em up, and this budget year we'll go forward with facility closures in a variety of places."
Two facilities, one in Jacksonville and one in Tinley Park, already face closure as part of an effort to get people with mental disabilities and illnesses out of large institutions and into community care. The other institutions that could be targeted remain a mystery.
Five places that have reason to worry are Chester, Dixon, Lincoln, Murphysboro and Rockford. Quinn proposed closing institutions in those cities last year in a budget fight with legislators. He dropped the closure plan when lawmakers provided more money to operate the facilities, but they could be at the top of a new closure list.
HOW DEEP WILL THE MEDICAID CUTS BE?(equals)
Quinn says the $14 billion Medicaid program should be chopped by $2 billion. It's not clear what that will mean for the 2.7 million Illinois residents who depend on the program for some or all of their health care.
The governor could propose cutting rates paid to doctors and hospitals for providing care to the poor. That's what he tried last year, unsuccessfully. It's easier to call for cutting doctors' pay than cutting benefits directly, but that doesn't mean it's painless. Some struggling hospitals could reduce services or even close. More doctors might refuse to see Medicaid patients.
Other options would hit patients more directly. Quinn could propose tightening eligibility so that fewer people qualify for care. Or he could try to eliminate optional services, such as long-term nursing home care or help with some prescriptions.
Quinn has talked about transforming Medicaid into what he calls a "wellness system," suggesting he has a broad overhaul in mind.
HOW WILL QUINN PAY FOR NEW SPENDING?(equals)
In his State of the State address, Quinn offered a handful of proposals that would add to the state's budget difficulties by increasing costs or reducing revenue. He said little about how he would fill the new hole, promising that details would come in his budget.
So now Quinn has to explain how he plans to replace the $160 million Illinois would lose under his proposal to eliminate a tax on natural gas. He also has to spell out his ideas for $140 million worth of tax breaks to families with children and to businesses that hire unemployed veterans. Other proposals, such as spending more on early childhood education, boost the total cost of his ideas to perhaps $500 million.
In his speech nearly three weeks ago, Quinn said, "To create jobs and grow our economy, we must continue to invest in Illinois and help everyday people."
Now the pressure's on him to explain how to do that while also digging out of the state's deep budget hole.
WHAT DOES HE WANT TO DO ABOUT PENSION COSTS?(equals)
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