Updates on health care reform in Illinois

August 2017

After more than eight angst-filled months battling health care changes that threatened the lives of millions, we were needing a break. And by "a break" we mean taking time to look at all the health care changes being proposed here in Illinois that will impact the lives of millions.

 Amping up Medicaid Managed Care
IL care coordination regions
This month's Medicaid contract awards kick off phase two of a transition begun in 2011. At that time, like many other states, Illinois shifted its fee-for-service program to a system that administered care through for-profit insurers. The awardees that will serve Illinois' roughly 2.7 million Medicaid members for the next four years:
  • Blue Cross Blue Shield of Illinois
  • County Care Health Plan
  • Harmony Health Plan
  • IlliniCare Health Plan
  • Meridian Health
  • Molina Healthcare of Illinois
Besides sweeping in a new MCO lineup, this phase brings further changes to how Medicaid is set up.  All current programs are being rolled into one, eliminating the multiple acronyms that separated populations such as dual eligibles being served by one set of plans, adults with disability by a different one, and Medicaid expansion in yet another. The redrawn regions will now be 

And while managed care had been limited to the more populous areas, every county will now be covered - making for an especially challenging transition, as many rural counties have limited to no experience with managed care.

Expected go-live for this phase is January 1, 2018, with members moving from their current providers such as Centene or Aetna to one of the above providers.

 1115 Waiver Update
As you may know, Illinois has been seeking approval from the Centers for Medicare and Medicaid Services for an 1115 waiver to better integrate the state's behavioral and physical health systems.

At the August 17 Medicaid Advisory Committee meeting, Felicia Norwood, director of the state Department of Healthcare and Family Services, reported that the state is first working to obtain CMS approval for an Integrated Health Homes model of care, which will most directly impact those in Medicaid managed care. The intent of the IHH is to broaden care coordination to include providers, hospitals, and social service organizations; under IHH, managed care plans will be expected to use this IHH model to ensure that a person's medical, behavioral, and social needs are being met in a more comprehensive manner.

HFS hopes to secure IHH approval by September 1, and then move forward with the 1115 waiver. Public hearings on the 1115 waiver are set for September:
  • Springfield - Thurs, Sept 8, 10:30 am - 1 pm. Howlett Auditorium 501 S 2nd St
  • Chicago - Fri, Sept 9, 10:30 am - 1 pm. Assembly Hall Auditorium 100 W Randolph St
 In Case You Missed It

Disability Integration Act - Recent moves to eliminate the ACA also would have impacted funding for moving people with disabilities from institutions to community settings. Despite the temporary pause in ACA repeal efforts, advocates are continuing to support bills that strengthen people's right to stay in the community. The Disability Integration Act of 2017 would apply to state and local governments that provide institutional placements for individuals with disabilities who need long-term assistance with daily living activities or health-related tasks, and to insurance providers that fund such long-term services. It would prohibit them from denying community-based services that would enable such individuals to lead an independent life.

Personal Needs Allowance - Illinois SB1353 passed the both houses this summer and awaits the Governor's signature. The landmark measure raises the personal needs allowance for the first time since 1987. Residents in community integrated living arrangements (CILA) and intermediate care facilities for people with developmental disabilities (ICF/DD) have been limited to retaining only $30 and $50 a month, respectively,  from their public benefits checks, for personal purchases; the bill raises both PNAs to $60. (Although this change was made administratively as part of the budget process, the bill would codify it as law.) ONE Northside has been leading the effort, and continues to push to get the bill signed. You can support these efforts by contacting Governor Rauner's office.

 From Our Social Media

On Facebook
"You can't just look at premium rates," says our CEO @BarbAOtto about IL's proposed public option plan http://bit.ly/2w7QKPt in Crain's Chicago Business

On Facebook
Medicaid helps people with disabilities stay in the community rather than institutional care. Read our 1-pager: http://bit.ly/2w2sD4J

On Twitter
The CBO report says that ending #ACA subsidies would increase premiums by 20% by 2018 https://t.co/8zfNPmwsKW

On Twitter
Does the health care debate mean a new life for Medicaid? http://bit.ly/2i37ODlĂ‚ 

We will continue to work together, and to keep you informed.

John Jansa
Health & Disability Advocates

Please forward this newsletter to friends or colleagues who are interested in how the ACA and other developments are impacting health care in Illinois with. If you have questions or suggestions, email us at info@illinoishealthmatters.org .
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