SPRINGFIELD --- Hundreds of thousands of poor Illinoisans would lose health coverage, prescription drug discounts for seniors would be dropped and dental care for adults would be greatly curtailed as part of $1.6 billion in budget cuts lawmakers approved yesterday.



The major Medicaid reductions ignited anger in some lawmakers who say the cutbacks will jeopardize the lives of the state's most vulnerable residents.



"I don't know where it's written in the law that this has to be balanced on the backs of poor people, on the backs of seniors, on the backs of the aged, blind and disabled," said Rep. Mary Flowers, D-Chicago.



But supporters argued failure to approve the bill could lead to cuts throughout state government and result in collapse of the entire Medicaid system.



The House voted 94-22 to approve the measure, and the Senate approved it 44-13 late Thursday. But cuts are only part of the equation to fix Medicaid. Gov. Pat Quinn is seeking support for a $1-a-pack increase in the state's cigarette tax to help fill an overall $2.7 billion gap in Medicaid funding for the budget year that starts in July.



Among the estimated big-ticket savings: $350 million through tighter screening that could remove hundreds of thousands of people from Medicaid coverage; $49.8 million by reducing the number of people eligible for Family Care; and $72.2 million from eliminating a state-paid pharmacy assistance program called Illinois Cares Rx, which provides discount drug coverage for 180,000 low-income seniors and people with disabilities.



State and federal spending on Medicaid in Illinois is about $15 billion a year.



William McNary, co-director of Citizen Action/Illinois, urged lawmakers to keep the drug discount program intact. "We believe that these cuts are very damaging," McNary said at a House hearing. "People will not get less sick."



But Rep. Patti Bellock said the far-reaching cuts provided a path for "saving people's lives." Bellock, R-Hinsdale, said the top goal of she and other negotiators on the bill was to protect the "most fragile, vulnerable."



In addition, nursing homes and hospitals are among providers that stand to see payment rates reduced to save about $240 million.



In addition, payment rates for nursing homes and hospitals are being reduced to save about $240 million.



"There is nothing in this bill that everyone is completely happy about," said Rep. Sara Feigenholtz, a Chicago Democrat sponsoring the proposal.



Negotiations also produced a separate bill that revived Cook County Board President Toni Preckwinkle's desire for a waiver that will allow coverage of more patients into a county Medicaid network backers say will cost the state nothing.