Cook County hit a $100 million jackpot over the weekend.In a little noticed but crucial decision announced Friday night, the federal government signed off on a request by county board President Toni Preckwinkle to enroll 114,000 low-income people a year early in the Medicaid program.For the county, the decision is worth as much as $100 million a year, since its network of hospitals and health clinics already is serving most of the patients free of charge. The tab now will be picked up by federal taxpayers under a provision of Obamacare, rather than by Cook County taxpayers alone.
Preckwinkle was discussing drug policy and how she felt drug treatment should not be a part of the criminal justice system. She was defending the decision by Chicago city officials to decriminalize small amounts of marijuana. And her comments were in reference to Reagan’s “war on drugs,” which President Richard Nixon started. During Reagan’s tenure, First Lady Nancy Reagan started the “Just Say No” campaign against drugs.Preckwinkle made those comments in downstate Illinois. Reagan was born in Tampico, Illinois.Preckwinkle helped Obama challenge the signatures of his primary opponents to run unopposed in his 1996 state senate race. Obama often reminisces about this race as a heroic, Rudy-esque foray into politics in which he overcame all odds to win.
On issue after issue, Preckwinkle presented Obama as someone who thrived in the world of Chicago politics. She suggested that Obama joined Jeremiah Wright’s Trinity United Church of Christ for political reasons. “It’s a church that would provide you with lots of social connections and prominent parishioners,” she said. “It’s a good place for a politician to be a member.” Preckwinkle was unsparing on the subject of the Chicago real-estate developer Antoin (Tony) Rezko, a friend of Obama’s and one of his top fund-raisers, who was recently convicted of fraud, bribery, and money laundering: “Who you take money from is a reflection of your knowledge at the time and your principles.” As we talked, it became increasingly clear that loyalty was the issue that drove Preckwinkle’s current view of her onetime protégé. “I don’t think you should forget who your friends are,” she said.
Illinois' other structural problem is Medicaid. In FY 2010, Medicaid accounted for 23 percent of the state's budget and that figure is going to grow under the Affordable Care Act. Under the best case scenario Obamacare will only raise spending 3.3 percent above the current baseline by 2019. However other scenarios suggest the increase could be as much as 20 percent by 2020.Rather than address these structural problems, Illinois has resorted to heavy borrowing to cover its obligations. As a result, per capita debt in Illinois is the second highest in the nation at nearly $10,000 (NY is number one). And largely because of this high level of debt, Illinois' bond rating is the worst in the nation. Moody's downgraded the state most recently in January of 2012.
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