Updates on healthcare reform in Illinois   

July 2018

We haven't written before about the fight over the State's overtime cap for home care workers. It's a policy that impacts people with disabilities, their personal assistants, the Department of Human Services, the union representing the workers, the legislature and the Governor's Office. Below is a summary of the latest development in a struggle that is expected to continue. We will keep you updated. 
 Labor board overtime decision

A limit on overtime hours for in-home caregivers was recently upheld by the Illinois Labor Review Board (ILRB) following a complaint lodged by SEIU, the union representing home care workers in Illinois.

SEIU initiated the complaint in 2016, claiming the State had failed to bargain with the union when they attempted to implement a 45-hours per week limit for workers serving people with disabilities under Illinois' Home Services Program. An administrative law judge in 2017 sided with the union, finding the Rauner administration had unfairly implemented the rule.
The ILRB's recent decision, however, overturns the judge's 2017 ruling. They determined the State had no obligation to bargain about the overtime issue and, therefore legally implemented the overtime cap. They also ruled the overtime policy only limited the consumers' rights and did not suggest an actual employment relationship between the State and the workers.
Advocates have pushed the state to change their overtime policy, explaining that their personal assistants often work more than 45-hours per week in order to earn sufficient income. SEIU has already filed an appeal to the appellate court. 
The ILRB is expected to approve and release their written decision at their next meeting on August 15. The union has already filed an appeal with the First District Appellate Court in Chicago.

  SNAP equipment and Illinois farmers
Farmers markets have become a large and growing supplier of healthy food to those using SNAP benefits. Now a large percentage of those using SNAP benefits at farmers markets is about to lose that ability.

Since 2012, the USDA has run a Free SNAP Wireless Equipment Program to provide mobile devices to farmers markets, and 2,500+ markets participate. But the new administrator of the program has chosen to work with a different set of companies, which may eliminate or greatly delay the ability of markets to obtain free equipment, essentially making SNAP participation prohibitive.

The Novo Dia Group, an Texas firm that processes about 40% SNAP transactions at farmers markets nationwide, plans to end its service this month, leaving about 1,700 of the more than 7,000 markets that offer SNAP with no way to serve low-income customers.

The shutdown comes at the height of the growing season for Midwestern farmers.

Some food stamp recipients may soon lose access to farmers market benefits -Washington Post 

 Elsewhere in healthcare news
Roskam's new ACA bill Rep. Peter Roskam, from Illinois's 6th district (Palatine and surrounding area), introduced a bill July 7 that constitutes yet another attack on the ACA. H.R.6311 would  modify the definition of "qualified health plan" to create a "copper-level" plan. It also would permit individuals to use premium tax credits to offset the costs of catastrophic health plans, plans that under current rules, are not deemed as sufficient coverage.
Rep. Roskam is the Chairman of the Ways and Means Subcommittee on Health, a very powerful vantage from which to offer ways to undermine the ACA using the budget process. Noting his aversion to meeting with constituents, advocates started carrying a cardboard cutout of the congressman to town halls and created a Twitter account for it, @FlatRoskam.

CMS suspends risk adjustment program payments - Citing a February ruling in the US District Court of New Mexico, CMS announced July 9 that  disburse $10.4 billion in risk adjustment payments for plan year 2017. The risk adjustment program was intended to stabilize the market and to reward insurers whose medical loss ratio (portion spent on care) is over 80% by by transferring funds from those with lower MLR. CMS suggested that they would have liked these payments to continue but had honor the judge's order.

Region V sending new Medicare cardsOur regional CMS office has started mailing new Medicare cards to people in Illinois. People can sign into MyMedicare.gov to see if their card has been mailed; and if so, they can print an official card. They can call 1-800-MEDICARE (1-800-633-4227) if something needs to be corrected, such as their mailing address. CMS stays they're committed to mailing new cards to all people with Medicare by April 2019.

John Jansa
Smart Policy Works

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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