Illinois became the latest state Monday to implement a central part of President Barack Obama's health care law by expanding Medicaid to cover low-income adults who don't have children at home.
Gov. Pat Quinn signed the state legislation into law, which will allow an estimated 342,000 Illinois residents to enroll by 2017.
"Some would call it Obamacare. I call it `I Do Care,"' said Quinn, surrounded by health care advocates at the University of Illinois at Chicago. "It's not a privilege to have decent health care; it's a fundamental right."
About half of U.S. states are moving forward on expanding the health care program for the poor and disabled, which is a provision in the Affordable Care Act approved in 2010. Last summer, a U.S. Supreme Court decision made it optional for states to take it up. More than a dozen Republican-led states have opted out.
In Illinois, and other states expanding Medicaid, enrollment begins Oct. 1 and coverage begins next year. Up to half a million uninsured will be newly eligible for coverage with the federal government footing the bill the first three years.
The intricate measure was closely watched in the president's home state and went through, at times, heated debate. A last-minute amendment that gives more flexibility to the state's mental health institutions created ripples. U.S. Sen. Dick Durbin, the No. 2 Senate Democrat, popped in during the floor debate as some Republicans expressed worries about future funding and long-term sustainability.
The tone was starkly different Monday as members of the Illinois Hospital Association, anti-poverty groups, AARP and sponsoring lawmakers -- state Rep. Sara Feigenholtz and Sen. Heather Steans -- called it an historic measure that would give better access to health care and take advantage of federal money.
Some said the move would lessen the use of emergency rooms as a primary source of care, while others said it would improve efforts to prevent illnesses.
"The passage of this bill really is going to change the health trajectory of hundreds of thousands, the most vulnerable in our state," said Nadeen Israel of the Chicago-based Heartland Alliance.
The expansion will cover those making up to 138 percent of the federal poverty level, or just under $16,000 each year for an individual. After the first three years, states would gradually pick up a percentage of the costs.
Illinois has lagged slightly behind other Democrat-led states in carrying out Obama's cornerstone domestic achievement.
For three years, Quinn had hoped that Illinois could take over the health insurance marketplace, an online insurance shopping site that is available Oct. 1. However, Illinois lawmakers adjourned earlier in the summer without voting on the proposal. Unless lawmakers approve a plan in the fall, the state will partner with the federal government beyond the first year.
Quinn pushed the Obama connection to Illinois on Monday and said he wanted to sign the bill ahead of the president's scheduled visit to the state. Obama is expected to speak Wednesday at Knox College.
"I'm going to bring this bill on Wednesday to Galesburg and say to the president, `We got the job done,"' Quinn said.