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SPRINGFIELD — Illinois lawmakers moved forward Monday on a historic expansion of Medicaid, but heavy lifting on the state’s most pressing issues, pensions, a budget, expanded gambling, gay marriage and gun control, remained with the clock ticking toward a Friday deadline.

After nearly three hours of debate, the House approved a key part of President Barack Obama’s health care law. The proposed Medicaid expansion would cover low-income adults who don’t have children at home, and up to 500,000 uninsured Illinoisans would be newly eligible for coverage. Under the multifaceted measure, 342,000 people are expected to enroll by 2017.

“This is the cornerstone of our president’s agenda. Many of us have been waiting for this moment,” said Rep. Sara Feigenholtz, a Chicago Democrat and bill sponsor. She tamped down questions from Republicans over timing by saying those who need care can’t wait another day.

“They will become insured for the first time in history,” she said.

House lawmakers approved the measure 63-55. It heads back to the Senate after House changes. Gov. Pat Quinn, who is in favor, said it would “improve the health of hundreds of thousands of the most vulnerable people across Illinois.” U.S. Sen. Dick Durbin, the Senate’s No. 2 Democrat, made an appearance during the floor debate but didn’t speak.

State Rep. Sue Scherer, D-Decatur, was among a small number of Democrats who voted against the measure. 

Scherer said she voted against it because of the uncertainty of future costs.

“We’re not 100 percent sure of what the costs even will be,” Scherer said. “This is a burden we can’t put on our children and grandchildren.“

The expansion would cover those making up to 138 percent of the federal poverty level, or just under $16,000 annually, and the federal government would pay for it the first three years. After that, states would gradually pick up a greater percentage of the costs.

“This isn’t a case of not caring about people who need health care. This is the case of us being responsible legislators,” said state Rep. David Harris, an Arlington Heights Republican. “We have a duty to craft a budget that puts this state on a sound financial footing. This bill weakens our financial footing.”

Talk of Illinois’ financial problems set the tone for the week ahead.

Lawmakers are working on a budget agreement that they say will avoid cuts to education and immediately pay off bills the state owes human services providers. Democrats in the House and Senate worked together on the spending plan, and key initial votes in the House are expected this morning.

Quinn had proposed cutting K-12 education by about $300 million, reductions he said were necessary because the state has yet to resolve its nearly $100 billion pension crisis. But Democratic budget negotiators said they were able to avert those cuts because of higher-than-anticipated revenues this year and projected for the fiscal year that begins July 1.

The two chambers remain without a deal on the pension problem, which is the worst of any state in the nation.

The sponsor of a bill to expand gambling in the state, including five new casinos, said talks on his plan were moving along and would be ready for consideration by the end of the week. Rep. Robert Rita, a Blue Island Democrat, told reporters Monday that the tax rates for the new and existing facilities are still being worked out.

Lawmakers also face a June 9 deadline to legalize concealed carry after a federal appeals court ruled Illinois’ last-in-the-nation ban unconstitutional. A bill backed by House Speaker Michael Madigan cleared the House last week, but Quinn, Senate President John Cullerton and Chicago Mayor Rahm Emanuel oppose it because it strips Chicago and other cities’ rights to their own gun restrictions.

Spokeswoman Rikeesha Phelon said Monday night that Cullerton planned to call the House version for a committee vote, perhaps as early as today. But she said the committee would also vet an earlier Senate plan that likely will be rewritten in a way that includes the House concealed-carry provisions but without the pre-emption of local regulations, which Cullerton has called “offensive.”

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