Gov. J.B. Pritzker could move forward with a campaign plan to create a Medicaid buy-in program after lawmakers failed to override his veto of a bill that would have restricted his ability to unilaterally request waivers from the federal government for health programs.
During the fall veto session, lawmakers only addressed one veto and they failed to get enough votes to override it. Pritzker vetoed seven bills that the General Assembly approved. The governor signed nearly 600 bills. He used one amendatory veto.
Pritzker vetoed Senate Bill 2026 entirely. State Sen. Sue Rezin, R-Morris, the bill's chief sponsor, said it would have protected people with pre-existing conditions by giving legislators the power to request federal health program waivers, rather than unilateral power to the governor.
“If the governor feels that there’s a waiver he needs to apply for, instead of giving him full authority to make that decision, the bill says that essentially that by a vote of the [Senate] and the House that we are able to provide that,” Rezin said.
Despite the bill passing unanimously in the Senate this Spring, Rezin’s override attempt failed.
State Sen. Heather Steans, D-Chicago, said the measure was not needed.
“We have a very strong bipartisan Medicaid working group that is consistently with the governor’s administration,” Steans said. “They don’t take steps without the participation and communication with the bipartisan Medicaid working group.”
Without the restrictions, the governor has the authority to apply for waivers. One possible waiver Gov. J.B. Pritzker has said he could request would allow people to buy into Medicaid.
Pritzker said in his veto of the bill that he doesn’t plan on reducing anyone’s benefits. Pritzker included a Medicaid buy-in program in his IllinoisCares program, which he touted on the campaign trail leading up to the 2018 election. He has yet to discuss the proposal in detail.
Davesurance.com insurance broker Dave Castillo said a proposal could come up during the 2020 election cycle as some presidential candidates have proposed Medicaid-for-all programs. Castillo said a state-specific Medicaid buy-in program could have unintended consequences, such as specialist rationing or higher costs for other insurance plans.
“If these companies start losing the higher paying commercial business and increase Medicaid business, there’s a fear that this will drive costs even higher on the commercial side and cause a narrowing of networks currently established with these Medicaid managed care organizations,” Castillo said.
It’s unclear if or when the governor would pursue the idea of a Medicaid buy-in program.