Gov. Jim Edgar’s proposal to expand the state’s Medicaid program is receiving mixed reviews as champions are claiming the plan offers significant reform while skeptics are saying its funding levels fall short.

The proposal, announced Tuesday, calls for a restructuring of the state’s eligibility requirements for Medicaid assistance and a modest injection of new money into the program.

Illinois maintains a tiered structure for Medicaid eligibility based on age. For children up to age 5, it covers those whose families make up to 33 percent above the poverty line. For children 5-14, it offers Medicaid to those up to the poverty line. And for children 14-18, the eligibility level is up to 50 percent.

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Edgar’s changes will allow for all children, ages 1-18, whose families make up to 33 percent of the poverty line, to be eligible for Medicaid assistance. For a family of four, the poverty line is $16,032; for families of three, it is $13,322.

Tuesday’s plan authorizes $24.3 million in new funds for the remainder of the fiscal year $14.8 million in federal money made available by the 1997 Balanced Budget Act and $9.5 million in state money. The proposal also offers $31.2 million in federal money for fiscal year 1998-99, and $19.4 million in state aid. In August, $24 billion were appropriated for state grants aimed at uninsured children. The bill mandated that each state may receive $620 million over five years for the improvement of Medicaid.

Under the new plan, a bi-partisan commission made up of legislators and consumer advocates will study the Medicaid system and make recommendations on further expansion efforts.

According to Edgar’s estimates, 40,400 of the state’s 300,000 uninsured children and about 2,900 uninsured pregnant women will be covered by the plan, which goes into effect Jan. 5.

Because federal funds have been in the hands of the state for three months, some are calling Edgar’s plan late.

John Schmidt, Democratic candidate for governor, argues that the state waited too long in authorizing the funds, and that not enough money was allocated.

Becky Carroll, Schmidt’s press secretary speaking on behalf of the candidate, said that thousands of poor children are left uninsured by the plan. This kind of neglect, she said, is unacceptable when the money needed to insure these children is available.

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They knew this money was coming, Carroll said. Why weren’t they ready?

There’s a whole pool of money available that isn’t being used. There are a lot of families who can’t afford health care coverage, who won’t be insured by this plan they have nowhere else to go.

Carroll said Medicaid should be expanded to cover all children whose families make up to 50 percent of the poverty level. Without insuring these children, she says significant reform will never evolve.

John Webber, spokesman for Edgar, said the governor’s plan, though not comprehensive, constitutes an ambitious effort to expand the Medicaid system in Illinois. He said the primary reason for delaying its implementation was to make sure money would be available in the future.

It takes time to put together these kinds of agreements, Webber said. The dollars have to be there in subsequent years, or all of this means nothing.

Webber said that further expansion efforts will be examined carefully, and will hinge on recommendation from the commission. But, he said, they have not been ruled out.

We’re going to look at the best ways to set up subsequent phases of the plan, he said. And we’re going to do that in a way that’s equitable and sensible.

But, what we have now is extremely significant.

Rob Kilbury, co-chairman of the Board of Directors for the Campaign for Better Health Care, expressed optimism with the new plan, but said it is only a first step. Kilbury argues that Edgar must expand the system in the future, and must do so as expeditiously as possible.

Everyone’s entitled to health care coverage, Kilbury said. The lack of health insurance for the working poor is a tremendous problem. This is a good first step, but we’re expecting additional efforts to include a broader constituency.

Sen., Dave Luechtefeld, R-Okawville, expects health care to receive significant attention in the spring session of the General Assembly. Though not familiar with the details of Edgar’s proposal, he acknowledges the need for expanded health care coverage. Luechtefeld is not certain how to achieve this end, but pledges to examine the alternatives next year.

It’s very likely that health care will be a big issue in the spring now that the other things (education and utility deregulation) are on the backburner, Luechtefeld said. Health care is extremely important, and we need to get more people under the cap, but you have to get the most bangs for the buck out of it.

If the money is available, you’d be foolish not to use it, but it needs to be thought through you can’t just jump into it.