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Illinois General Assembly Passes Medicaid Reforms, Safeguarding Health Coverage for Three Million Illinoisans who Depend on Medicaid

With unanimous votes in the House and Senate, advocates secure fixes to address the Illinois Medicaid eligibility and redetermination crisis

Springfield, IL— Protect Our Care Illinois (POCIL) applauds the Illinois General Assembly for successfully passing SB 1321, a Medicaid omnibus bill to improve the enrollment process and address other issues with the Medicaid system. The state has struggled for years to complete Medicaid applications in a timely fashion and prevent lapses in Medicaid coverage at renewal. We are hopeful that this bill will finally implement the reforms needed to streamline Medicaid renewal processes and better ensure our state’s three million Medicaid recipients will get the health care they need.

This legislation, sponsored by Senator Heather Steans, Majority Leader Greg Harris, and supported by stakeholders across the health care system will set into motion sweeping reforms throughout the Medicaid program. POCIL and its members Heartland Alliance, AIDS Foundation of Chicago, EverThrive Illinois, the Sargent Shriver National Center on Poverty Law, Legal Council for Health Justice, Thresholds and many others, worked tirelessly with the sponsors and other stakeholders to make sure the bill addressed the long-standing issue with redetermination cancellations and application delays. “Issues with Medicaid enrollees losing their coverage at renewal came up again and again,” said Senator Heather Steans. “We had to make it easier for eligible families to keep their benefits so they can have the peace of mind of dependable health coverage.”

The focus on Medicaid eligibility and enrollment stems from Illinois’s inability to process applications within the 45-day federal guidelines. There are currently over 100,000 overdue applications and the state is facing a lawsuit for the delays. Compounding this problem is a revolving door of Medicaid cancellations at renewal, leading to hundreds of thousands of Illinoisans losing coverage each month when many remained eligible. Over one-third of beneficiaries lose their benefits for some time at renewal.

POCIL focused on streamlining the application and renewal process by relying on electronic eligibility data and limiting the need to submit additional documentation. “Many Medicaid enrollees are struggling to make ends meet, working low-wage jobs and facing housing instability. That makes it tough to keep up with the all the letters and documentation currently required,” explained Heartland Alliance policy staff Dan Rabbitt. “We need to make the process for obtaining and retaining health coverage simple and easy for our neighbors who depend on it and this bill does just that.”

POCIL remains committed to strengthening Illinois’ Medicaid program and looks forward to continuing to partner with the Pritzker Administration, General Assembly, and other stakeholders to ensure Illinoisans can depend on the continuity of coverage and care necessary to stay healthy.

We look forward to a successful implementation of the bill and to building a strong health care system for all Illinoisans.

Protect Our Care Illinois Calls on the General Assembly to Protect Illinoisans From Looming Federal Health Care Attacks

The Trump Administration just unveiled its long-expected proposal to reverse health care protections for women, LGBTQ+ people and non-English speakers who are seeking care – issuing a draft rule that seeks to undo key parts of Section 1557 of the Affordable Care Act (ACA). Section 1557 is the nondiscrimination provision of the ACA – also known as the Health Care Rights Law – which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in any health program or activity any part of which received funding from HHS. This includes the Federal Health Insurance Marketplace and insurers that operate within the Marketplace.

The Trump proposed rule makes changes to non-discrimination protections in healthcare, significantly cutting back protections for women, LGBTQ+ people and people with limited English proficiency. It takes away express prohibition of discrimination based on gender identity and allows health insurers to discriminate in programs not directly receiving federal financial assistance.

“Protect our Care Illinois strongly opposes the Trump Administration’s insidious move to sanction discrimination and to further disenfranchise non-English speakers in our healthcare system,” says Protect Our Care Illinois Campaign Manager, Graciela Guzman.

This morning’s announcement is just one of the most recent myriad efforts to undermine access to healthcare and protections via the ACA and is a clear example of why we must call on our state officials to protect healthcare for Illinoisans.

We call on the General Assembly to protect Illinoisans from damaging and looming attacks on our healthcare through two steps that can be completed before the end of this legislative season on May 30th:

1. Support HB471 – the Freedom from Aggressive Insurance Increases Review (FAIIR) Act

Ensuring the Department of Insurance has the power to reject unreasonable and discriminatory rates is crucial to do right now. The relentless attacks on healthcare from the Trump Administration have not stopped and will only continue, leaving state officials in a position to try to fix problems for consumers long after the fact. This latest attack is one of the problems we do not want to be chasing. Illinoisans need protection, predictability, and stability when it comes to their healthcare.

Passing HB 471 is urgent and must be a priority for the General Assembly where the bill has successfully passed the House but has remained stuck in the Senate Insurance Committee. We call on our General Assembly members in the Senate to VOTE YES ON HB 471. 

2. Support SR 264 – the Protect ACA Resolution

On July 9th, a federal appeals court will hear the Trump-backed Texas vs. Azar case, which seeks to find the the entirety of the ACA unconstitutional. If this ruling is upheld, it would threaten the health and insurance coverage for over five million individuals in Illinois with pre-existing conditions, over two million people enrolled in Medicare, and 3.2 million people enrolled in Medicaid. In addition, this potential ruling would cause consumer protections to vanish overnight and would unleash chaos in our healthcare system.

We call on our General Assembly members in the Senate to affirm and protect the healthcare of Illinoisans and support SR 264 – the Protect ACA Resolution. 

Enrollment in ACA Marketplace Drops Due to Trump Administration Sabotage

On Wednesday, CMS released the near final weekly snapshot of enrollment numbers for the 39 HealthCare.gov states, including Illinois. This figure shows 8.5 million people enrolled in coverage during the latest six-week open enrollment period, a drop of 368,000 Americans. Illinois enrolled 314,777 individuals, a 7% drop in enrollees, and will have about 25,000 fewer Illinoisans covered this year through the Marketplace.

While the decrease is much smaller than what we feared, the data is still troubling: the number of new enrollees decreased significantly, indicating that those who rely more on proactive outreach and advertising to educate them about the Marketplace did not receive it this year. The Trump Administration could have chosen to bolster coverage for Americans by robustly supporting advertising, outreach and enrollment to properly reach and educate consumers. Instead, the Administration cut advertising by 90% and cut local help via Navigators by more than 80%. In a recent Kaiser Family Foundation poll, only one in four who buy their own insurance or are uninsured knew about the December 15th deadline. This is a clear sign that new consumers, most likely young adults, did not know about the open enrollment period due to the administration’s cuts in outreach and enrollment.

In addition to this lack of support for outreach and enrollment, the wide confusion caused by efforts from the administration and congressional Republicans to undermine and sabotage the Affordable Care Act (ACA) also bear an impact including the zero-ing out of the individual mandate penalty, the proliferation of short-term limited duration health insurance plans, and the fear instilled in the immigrant community about the public charge issue. The latest attack – the U.S. district court ruling on Texas vs. Azar- was released on the eve of the end of open enrollment for the majority of states in the US, including Illinois. The Supreme Court has upheld the ACA twice and this lower court decision doesn’t change that — yet it is another partisan attempt that fails to improve the health care system or lower costs for anyone.

Despite counterproductive actions by the Trump Administration, families from across the nation signed up for coverage. “The recent Marketplace enrollment numbers show that over 300,000 people in Illinois want and are seeking out affordable, comprehensive health insurance despite all of the congressional and administrative efforts to kill the ACA,” said Stephani Becker, Protect Our Care Illinois Steering Committee member and Associate Director of Healthcare Justice for the Sargent Shriver National Center on Poverty Law. As the November midterm election results showed, Americans are not willing to return to a time where income or pre-existing conditions might be a death sentence, especially in light of nonstop politically motivated attacks from the administration.

We are hopeful that under a new Governor in Illinois we can work on strengthening the Illinois Marketplace and focus on instituting state-based consumer protections so that we can reverse the trend of decreasing enrollment caused by the Trump administration’s efforts to sabotage the ACA.

Court Ruling Striking Down the Affordable Care Act is Misguided and Cruel – But Doesn’t Change Open Enrollment 2019

US District Court Judge Reed O’Connor made a decision on Friday to strike down the entirety of the Affordable Care Act (ACA) in the case Texas v. United States. This lawsuit threatens access to healthcare, quality of coverage, and financial protections for millions of people and their families.

This ruling is an assault on 133 million Americans with preexisting conditions, on the 20 million Americans who rely on the ACA for healthcare, and on America’s faithful progress toward affordable healthcare for all Americans. The ACA has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court. During the midterm elections, the American people forcefully rejected efforts to repeal and undermine the Affordable Care Act. Yet, the Trump Administration has made it clear that their priority is attacking access to critically-needed health care, protections for people with pre-existing conditions, and insurance for young people. Now, conservative courts are cowardly following suit.

While Protect Our Care Illinois is deeply disappointed in yesterday’s cruel and poorly reasoned decision by a judge in Texas, we want to share a few important points about its real impact:

  1. The ACA is still the law of land. Medicaid expansion, protections for people with pre-existing conditions, and the Health Insurance Marketplace remain intact. 
  2. This ruling does not take effect immediately and is being appealed. This is a lower court decision and national and state advocates are ready to appeal. 
  3. This decision does not impact the open enrollment period happening right now. As the Centers for Medicare and Medicaid Services stated today “the recent federal court decision is still moving through the courts, and the exchanges are still open for business and we will continue with open enrollment. There is no impact to current coverage or coverage in a 2019 plan.”

This means that your healthcare coverage and financial protections are not currently affected. So, you should continue to see your doctor when you need to. Those who haven’t done so already can enroll in a marketplace health plan today, December 15th, the last day of open enrollment.

Friday’s misguided ruling will not deter us: we will continue to fight in court for the health and well-being of Illinoisans and all Americans. Protect Our Care Illinois urges Texas and the coalition of challengers to work to reduce the number of uninsured families across our country instead of playing politics and trying to dismantle existing funding that makes coverage affordable and overturning critical consumer protections.

From the start, legal experts, across the political spectrum have questioned the merits of this case, and we firmly believe the appeals court will agree and reverse this decision based on weak legal arguments and the devastating impact it will have on the 20 million Americans benefiting from the ACA, including those in Illinois. We encourage you to resist this latest sabotage attempt and enroll in a comprehensive ACA insurance plan today.

Advocates Secure Short-Term Plans Limits, Safeguarding Comprehensive Care, Consumer Protections for Illinoisans

SPRINGFIELD – Protect Our Care Illinois applauds the Illinois General Assembly for successfully overturning Governor Rauner’s amendatory veto of SB1737, including the Short-Term Limited Duration Health Insurance Coverage Act. By overturning the Governor’s veto, the Illinois General Assembly joins health care consumers, advocates, and providers across our state to send a strong message that Illinoisans value access to comprehensive care.

SB1737, which will go into effect on January 1, 2019, is a bipartisan, negotiated bill that will protect Illinois from a new federal rule that turns back the clock on protections for consumers with pre-existing conditions. SB1737 will limit Illinois consumers’ exposure to short-term health insurance plans which provide diminished coverage parading as a more affordable option.

The bill keeps these plans truly short term by:

  • limiting their coverage duration to 180 days,
  • requiring clear and easily understandable language on all marketing and promotional materials, and
  • giving the Department of Insurance the regulatory muscle to actually safeguard consumers against the dangers of short-term plans.

The passing of this bill is a crucial arm in ensuring that Illinoisans that were at risk of the pitfalls of skimpy plans – being sold insufficient coverage, being denied for having a pre-existing condition or experiencing higher premiums – will now have stronger consumer protections instead.

Reaction by Rep. Laura Fine:

I am proud that the Illinois General Assembly voted to support SB1737. I was very concerned about Illinoisans with pre-existing conditions who were at risk of ending up in a short-term, limited duration health insurance plan and being left exposed to lack of care and exorbitant out of pocket medical costs in 2019 and beyond. This is a strong step to making sure we are prioritizing Illinois residents receiving access to comprehensive care, not skimpy plans that put them at financial and medical risk.

Reaction by Sen. Heather Steans:

Short-term health insurance plans can hurt consumers by not providing full medical coverage and leaving patients with high medical bills. The Short-Term Limited Duration Health Insurance Coverage Act is about protecting consumers and the insurance Marketplace in Illinois. By choosing to expand these shoddy plans, it is clear that the Trump Administration does not have consumers’ best interest at heart, so as a state we need to step up and protect patients from enrolling in plans that won’t cover their expenses. I applaud my colleagues in the Illinois General Assembly for putting Illinois’ consumers top of mind and establishing strong consumer protections against these skimpy plans.

Illinois now joins a list of states leading the way in taking action to combat the Trump Administration’s efforts to undermine the Affordable Care Act by promoting these low-quality plans that fail to cover basic health services and leave consumers in jeopardy of expensive medical bills.

Protect Our Care Illinois looks forward to working diligently to ensure this bill is implemented and that consumers statewide are aware of their new protections. We thank our robust network of statewide and national grassroots, legislative, and policy partners that helped secure this victory for Illinoisans. Thank you for your energy and passion. You are a testament that together we can win.

Post-Election Review and Success!

While you’re sorting through the ups and downs of the election results, we want to make sure you know that Tuesday night was a huge success for health care!

In numerous Illinois races – from the Governor’s mansion to the statehouse to Congressional districts – voters made clear that healthcare was a priority by voting for pro-health care candidates and against candidates who have opposed healthcare. At the federal level, voters in Idaho, Utah, and Nebraska approved ballot measures to expand Medicaid to cover uninsured low-wage adults while Maine and Kansas elected governors who are expected to pass Medicaid expansion. As exit polls demonstrated, health care was the wave in this election.

With the Democrats taking control of the U.S. House as of January 2019, legislation to slash Medicaid or end protections for pre-existing conditions will be stopped dead in its tracks. We celebrate the Herculean efforts of our grassroots partners and organizers across the state: YOU made it crystal clear that voters in Illinois and our nation have had enough of the war on healthcare.

While we applaud Tuesday’s healthcare results, we know there is plenty of work to be done to mobilize the energy, passion, and the moment of opportunity created by this election. Public consensus and support for the Affordable Care Act and Medicaid has never been higher. However, the electorate wants a continued commitment to not only safeguard their healthcare, but improve it — making it more affordable, and available to more people.

So, what’s next in Illinois?

1) Help regulate short term health insurance plans in Illinois and #StopJunkInsurance! Reach out to your IL House and Senate members during veto session for the Illinois General Assembly beginning November 13th to help secure a YES Vote. Sign up to take an assignment or help out in other ways.

2) Submit your comments on the “public charge” rule to the Trump Administration to protect immigrant families including safeguarding prenatal care, health coverage for kids, and much more! You have until December 10th. Send comments here: https://protectingimmigrantfamilies.org/#take-action-form

3) Get the word out that the deadline to sign up for health insurance in the 2019 Marketplace is Dec. 15th. Free, local help is still available around the state, thanks to dedicated assisters who help Illinoisans sign up for insurance. Last year, 8 out of 10 people got help paying for their health plan in the Marketplace. Spread the word with these outreach materials in 7 different languages!

We encourage you to celebrate the health care progress that we witnessed this week — and then get ready to keep fighting! Together we can win.

Rauner Administration is in Lockstep with Trump Administration’s New Guidance which Will Weaken Pre-existing Conditions Protections for State Residents

Effective immediately, the Trump administration issued new guidance for states seeking “state innovation waivers” under Section 1332 of the Affordable Care Act. This proposal is another example of the Administration working to sabotage the Affordable Care Act, allowing “increased flexibility” for states wanting to diminish their ACA marketplace and undermine protections for people with pre-existing conditions.

Under this new federal guidance, states are also no longer bound by a requirement that they cover the same amount of people as the ACA currently does in their state, leaving more Illinoisans at risk of being left without coverage. These changes could also allow states to use federal subsidy dollars to divert people from purchasing quality coverage on the Marketplace and into buying risky junk insurance, forcing those with pre-existing conditions to bear all of the risks of a destabilizing market.

Not surprisingly, Governor Rauner’s administration is embracing the Trump Administration’s new guidance under the premise of “more affordable choices.” However, we know that this is a false choice: skimpier plans just means that health care consumers will have to bear higher medical debt in the future and people with pre-existing conditions will have no choice at all — just higher premiums.

This new Section 1332 guidance is the opposite of what Protect Our Care Illinois tried to accomplish with legislation this session: limiting short term plans and giving the General Assembly a greater say over waivers. By vetoing HB 2624, the Short-term, Limited Duration Insurance Act and HB 4165, the “Do No Harm” Health Care Act, Governor Rauner sends a clear signal that access to comprehensive care and the opportunity for public input are not priorities for this administration.

While we do not have a crystal ball to see future changes, we do have strong precedent from the Rauner Administration that leaves us fearful for Illinoisans. We’ve already seen the uninsured rate start to inch back up in Illinois due to sabotage by the federal government; now it’s up to the states to protect the health of their residents. With these two vetoes, Governor Rauner abdicated his responsibility to look out for the best interests of Illinois residents and protect our care. We urge legislators to override his vetoes in November and protect Illinois’ consumers from continued threats to health care.

Protect Our Care Illinois denounces Public Charge rule aiming to punish immigrant families further

Today, the U.S. Department of Homeland Security has proposed a new regulation that could threaten the health and well-being of millions of children and families.

“Public charge” is a test used to decide if someone can obtain a visa or a green card. The administration has proposed a new definition of public charge that would block immigrant families from having a permanent, secure future in the United States. Under the new rule, immigrants who legally access health care, safe housing and healthy food programs could be denied admission to the country or refused a green card. The proposed rule also makes clear that earning low wages, having children, or dealing with a medical condition could be held against immigrants seeking a permanent future in the United States.

Experts warn that the plan would worsen hunger, unmet health needs, and other problems by making immigrant families — including families with children — afraid to get the help they need. Protect Our Care Illinois urges the Trump Administration to rescind its public charge proposal immediately.

It’s not final yet—but the clock is ticking. Federal law requires that the administration give the public an opportunity to comment on this expansive proposal until December 10, 2018. Take a few minutes now to post a public comment decrying this inhumane attack on the health and wellbeing of countless families, communities, and children at bit.ly/submitcomment. Commenters will not be required to give their address or divulge their immigration status. Advocates will post updates on www.protectingimmigrantfamilies.org, as available.

We need to move swiftly. Protect Our Care Illinois will submit public comments opposing the proposal, and we urge organizations and individuals across Illinois to speak out against this deplorable rule by submitting a public comment before the December 10th comment deadline.

 

Gov. Rauner, stop preventing Illinoisans’ access to quality healthcare!

Protect Our Care IL is deeply disappointed in Governor Rauner’s veto of two bills that would have protected Illinoisans against inadequate coverage and diminished access to care.  By vetoing HB 2624, the Short-term, Limited Duration Insurance Act and HB 4165, the “Do No Harm” Health Care Act Governor Rauner is sending a clear signal that access to comprehensive care and the opportunity for public input are not priorities for this administration.

HB 2624 was a bipartisan, negotiated bill that would have protected Illinois consumers from a new federal rule that turns back the clock on protections for consumers with pre-existing conditions. HB 2624 would have limited Illinois consumers’ exposure to short term health insurance plans which provide diminished coverage parading as a more affordable option. The bill would have kept these plans truly short term by limiting their coverage duration in a year, requiring clear and easily understandable language on all marketing and promotional materials, and giving DOI the regulatory muscle to actually protect consumers against these plans. With Governor Rauner’s veto, Illinoisans are now at risk of being sold stingy coverage that denies anyone with a pre-existing condition and will drive up premiums for everyone by pulling healthy, young individuals away from the marketplace.

Reaction by HB 2624 sponsor Rep. Laura Fine:

I am deeply disappointed with Governor Rauner’s veto of HB 2624. I remain very concerned about Illinoisans with pre-existing conditions who will end up in a short-term, limited duration health insurance plan and be left exposed to lack of care and exuberant out of pocket medical costs in 2019 and beyond.

HB 4165 would have ensured that the members of the General Assembly and the constituents they represent had input in a public process if any Illinois Governor decided to use a federal waiver to reduce healthcare access and treatment. In the last 6 months alone, we have seen Governors in many other states take up the Trump administration’s offer and encouragement to apply for federal waivers to restrict access to healthcare of its lowest income residents. The Do No Harm Healthcare Act would have given members of the IL General Assembly the power to provide a critical check and balance to review any attempts to weaken or reduce our healthcare. Unfortunately, with Governor Rauner’s veto, Illinois is similarly vulnerable to any upcoming attacks.

Reaction by HB 4165 sponsor Rep. Greg Harris:

Gov. Rauner’s veto of HB 4165 undermines sound policy and risks access to high quality comprehensive health care for all Illinoisans.  Rather than commit to public input, vetoing HB 4165 allows the Governor unchecked power to issue waivers that could let insurance companies drop your coverage for maternity care, substance abuse and mental health treatment, and prescription drug coverage, or to charge sky high rates to people with pre-existing conditions. We are seeing our heath care being treated like pawns in a game, moved not for the people who need healthcare, but by the insurance companies who profit from it.

We’ve already seen the uninsured rate start to inch back up in Illinois over the last few years due to sabotage by the federal government; now it’s up to the states to protect the health of their residents. With these two vetoes, Governor Rauner has abdicated his responsibility to look out for the best interests of Illinois residents and protect our care.

Protect Our Care Illinois urges Governor Rauner to sign HB 2624 in the wake of today’s action by the Trump Administration

Today, the Trump Administration continued its summer of sabotage of the health insurance marketplace by finalizing a rule to allow the sale of short-term health insurance with renewability of up to 3 years – essentially offering a shadow market to the comprehensive plans offered by the Affordable Care Act (ACA). While touted as an affordable option, these plans are cheap for a reason: they lock out people with pre-existing conditions and for those “healthy” individuals who are able to buy coverage, they exclude prescription drugs, maternity care, mental health coverage and even treatment of injury resulting from playing organized sports.

Fortunately, Governor Rauner has the opportunity to stop this rule from harming Illinois residents. A bill sitting on his desk – HB 2624 – limits the sale of short term health plans in Illinois to 180 days in any given year and would eliminate confusion by requiring insurers who sell these plans in Illinois to have clear, plain language on all sales and marketing materials.

Without action at the state level, the new rule will entice healthy individuals to purchase these inadequate plans and result in higher premiums or coverage denial for 5 million individuals in Illinois with illnesses and pre-existing conditions. According to the Urban Institute, this rule along with the elimination of the penalty for not having health coverage, would mean an estimated premium increase of 20% for Illinois consumers. In addition, 327,000 more Illinoisans would lack comprehensive health coverage, because they will either become uninsured or will end up in short-term plans rife with limitations, exclusions, and missing benefits.

Illinois should establish reasonable limits and consumer protections for short-term plans. Please join Protect Our Care Illinois in urging Governor Rauner to sign HB 2624 which will help protect Illinois consumers from financial hardships caused by the federal government’s new rule.