Republican Bill Brady says he'd work with Congress to repeal President Barack Obama's health care overhaul if elected Illinois governor, while Democratic Gov. Pat Quinn says he'd do everythig to implement the law if given a shot at a full term.
For Illinois voters who love or hate the Affordable Care Act, the choice next Tuesday between the top candidates for governor should be clear. Though the new law is a federal initiative, state governors will determine how it's implemented.
The country is electing 37 governors, and a Republican shift could slow the implementation of the law nationwide.
Quinn, who believes the federal law will protect Illinois consumers from unfair insurance price increases, says he would continue to accept federal money tied to the law and use it to beef up Illinois' weak regulatory powers over health insurers.
Brady calls the overhaul a government intrusion and says he would make sure Illinois joins 20 other states challenging the constitutionality of a requirement that most Americans buy health insurance. But he won't say what specific steps he'd take to turn his opposition into official state policy.
Governors can and have thrown obstacles into the law's path. For starters, Brady could refuse health law funding from the federal government, as has Minnesota Gov. Tim Pawlenty, a potential 2012 Republican presidential candidate. Brady won't say whether he'll go that far.
The law has been lucrative for Illinois. The state has been granted $1 million in federal money for planning implementation, and nearly $290 million has been awarded to state agencies, non-profits, nursing schools and hospitals through various provisions in the law.
When asked if he would instruct political appointees to refuse to implement the law, Brady said: "I can't answer a hypothetical."
Brady's campaign has had more help from the insurance industry, which has fought the health overhaul. Brady received $588,000 since July 1 from insurers, while Quinn has received $38,500, according to an analysis by the Illinois Campaign for Political Reform. As a state senator, Brady represents Bloomington, which is home to two insurance companies' headquarters. He has a long record of supporting legislation helpful to the industry.
"By our count, we have insurance companies accounting for 4 percent of (Brady's) receipts, while insurance companies account for just 0.32 percent of Quinn's receipts," said David Morrison of the Campaign for Political Reform.
Among the least popular of the federal law's requirements is that most Americans must by health insurance by 2014.
Advocates say the provision is necessary because the measure will expand coverage to an estimated 32 million uninsured Americans by the end of the decade, and insurers will have to provide coverage to everyone no matter how sick. The protection won't work unless consumers also are required to buy insurance, because people would otherwise wait until a health crisis to get insured. That would make insurance extremely costly.
The 20 states challenging the law argue Congress would be overstepping its authority by penalizing people for not buying insurance. Attorneys for the Obama administration have argued the penalties are allowed under Congress' constitutional power to regulate interstate commerce.
Political observers say getting 25 states, or half the country, on board with the lawsuit would be a significant milestone.
"We would join the lawsuit (with) other governors and attorney generals who feel it's unconstitutional and wrong and we'd work with the United States Congress to repeal it," Brady said of the law.
In contrast, Quinn's administration has jumped on the health care bandwagon.
Using federal money provided by the law, the state started a new insurance plan for people with health problems who've been uninsured for six months. The Illinois Pre-Existing Condition Insurance Plan has attracted nearly 2,000 applicants since it started Aug. 20.
"As a diabetic of 25 years, I can breathe easier for the first time since I lost my insurance two years ago," said David Zoltan, 33, of Chicago, one of the first to be insured through the plan.
A council appointed by Quinn is studying how to set up an insurance "exchange" required by the law, an online marketplace where consumers shop for insurance, similar to Travelocity for airfares. The law allows the federal government to set up an exchange in states that opt not to do it, but Illinois under Quinn would run its own.
More than 1 million Illinois residents will be eligible for federal tax credits to offset the cost of insurance starting in 2014, according to an analysis by the Lewin Group consulting firm for the advocacy group Families USA.
Ron Pollack, executive director of Families USA, said governors who oppose the overhaul eventually will realize it can save their states money by expanding the health safety net with federal dollars.
"Even though a candidate like Bill Brady blusters about health reform being a problem and needing repeal, ultimately virtually all governors are going to want to cooperate to get it done properly in their state," Pollack said.
Associated Press writers Sophia Tareen in Chicago and Christopher Leonard in Collinsville contributed to this report.