CHICAGO – Illinois lawmakers soon will face two critical decisions over how to fully carry out President Barack Obama’s health care overhaul.

With attention turning in 2013 to how states will implement the health law, Gov. Pat Quinn is pushing legislation to establish a state-run health insurance exchange to help middle-class citizens and small businesses, along with a multibillion-dollar expansion of Medicaid to cover the poor. While the state’s Democratic leaders generally have supported the new health care law, neither proposal will be a slam dunk for passage.

Consumer groups and the insurance industry are warring over whether the state should be able to negotiate with insurers to get lower premiums for people participating in the health insurance exchange. It’s not clear where the governor stands, but it would be difficult to pass a bill over the industry’s objections.