In Illinois budget politics this year, regarding funding for the young, the old, and the ill, the golden rule is this: she who has the gold makes the rules.
An overhauled budget process in the Illinois General Assembly has empowered individual House and Senate appropriations committee lawmakers to allocate the state's budget pie, leaving approximately $12 billion -- 50% of the state budget -- in the hands of State Rep. Sara Feigenholtz (D-Chicago) and State Senator Heather Steans (D-Chicago).
Feigenholtz and Steans chair the human service appropriation committees in their respective legislative chambers. Their thankless job is to slice $1.2 billion from programs that feed, house, treat, and care for the mentally ill, abused children, destitute seniors and those living with HIV/AIDS.
Their aim is to do the least possible harm to these programs. They are also reworking Governor Pat Quinn's proposed budget.
And an announcement 11 days ago by Quinn's Illinois Department of Public Health that its plans next year to restrict access to the AIDS Drug Assistance Program to new applicants with incomes at or below 300% of the federal poverty level, versus the current 500% limit, illustrates the problem that Quinn and Feigenholtz and Steans face.
There is not enough gold to go around.
Jointly funded by the federal and state governments, ADAP provides HIV medications each month to more than 4,200 Illinoisans who have no other means to afford their lifesaving medications, which can cost $18,000 or more per year. The state's public health agency, which attempted to bury the bad news by unveiling its decision on Friday April 15, wants to the change eligibility criteria on July 1, which would affect 100 or more individuals annually, saving the state $1.3 million, or just under 3% of program costs.
The decision has, however, really ticked Feigenholtz off.
"I have been working like a dog to stop this looming restriction to living-saving HIV/AIDS medication from happening, and I am furious with this decision," said State Rep. Sara Feigenholtz (D-Chicago), Chair of the House Human Services Appropriations Committee. "The HIV/AIDS drugs program is not where administrators, sitting in their offices at the Illinois Department of Public Health, should cut," said Feignenholtz.
And the 16-year veteran lawmaker from Chicago's north lakefront has her eye on those offices.
"The human services appropriations committee this year plans to start its budget cuts on the department's $882,000 annual Chicago office rent on south Michigan Avenue before it cuts life-saving medication," said Feigenholtz.
But Feigenholtz, conscious of the need to cut $1.2 billion from the budget, stopped just short of a flat-out promise to reverse the decision in full.
The threatened funding for HIV/AIDS medication also swiftly appeared on Steans' list of budget concerns, but with the caveat that she too bears the budget burden of too little gold in the state coffers.
"I certainly will fight to address ADAP funding in Senate appropriations, but cannot make any assurances. We have to cut an additional $1.7 billion from the governor's introduced budget. It is thus extremely challenging and everything is on the table."
Illinois' top AIDS activist accurately summed up the situation in which Illinois finds itself.
"This is a sad day for the fight against HIV/AIDS in Illinois," said David Ernesto Munar, President/CEO of the AIDS Foundation of Chicago. "The new policy will keep ADAP out-of-reach for hundreds of individuals who have nowhere else to turn for help. Many will simply forgo treatment..."
Let's be clear. To forgo would AIDS drug treatment would amount to death. Period.
And it's important to be fair to Governor Quinn. He's not indifferent to the issue. In fact, Quinn urgently ransacked the state sofa cushions to find and redirect an additional $7 million toward ADAP to avoid its looming financial collapse in 2009. He gets it.
And a political leader who really "gets it" is Greg Harris.
Harris, who is a legislative colleague of Feigenholtz and Steans from a state house district on Chicago's north side and who is living with HIV/AIDS himself, clearly frames the issue.
"There is no doubt that we will be making painful cuts all around this year. But cutting programs that keep people alive should be the absolute last resort, not the first. Whether it is providing life-sustaining treatment to people living with AIDS or with breast cancer, saving lives has to be a moral priority for the State," said Harris.
He's right, of course.
"We're going back to the budget drawing board," Feigenholtz said.
Let's hope she and Steans have the Midas touch.