Updates on healthcare reform in Illinois

June 2018

The end of May brought with it a budget without our lawmakers even having to stop the clock, and a cornucopia of legislation passed and forwarded to the governor. There was also  the requisite  good news and alarming news from beyond  Illinois'  borders.
 Sent to the governor!

We have been tracking several important pieces of legislation, and are delighted to report that these have made it to the governor's desk.

HB 2624 SA3 - The Short Term Limited Duration Health Insurance Coverage Act (sponsor: Heather Steans). Developed with help from Protect our Care Illinois in response to the Trump Administration's proposed regulations to expand short-term insurance terms from three months to a year and make them renewable. These insurance plans are not bound by ACA consumer protections and can deny coverage for pre-existing conditions; analysts warn extending their duration would undermine risk pools and cause Marketplace premiums to soar. The bill would limit these plans to 90 days, ban issuers from discriminating against people with pre-existing conditions, and require warnings that the plan may not provide all needed coverage.  Sent to the governor.

HB 4383 - Ensuring Patient Continuity of Care (sponsors: Feigenholtz/Steans).  The bill gives Medicaid managed care patients the  ability  to remain with their primary care provider if  he/she is no longer contracted with the patient's managed care organization (MCO) Currently, in such cases, patient s   are assigned a new  PCP , often without the patient's knowledge or input with the effect of drastically  disrupting continuity of care. Sent to the governor.
HB 4165 - The Do No Harm Healthcare Act (Sponsor: Greg Harris). The bill would prevent the State from applying for any federal waiver that would reduce or eliminate ACA-mandated protections or coverage that went into effect on January 1, 2017. The Rauner Administration is on record as opposing the bill. Sent to the governor.

HB 4096 - Medicaid single drug formulary (Sponsor: Greg Harris).  In an attempt to standardize drug coverage among Medicaid managed care patients, the Department of Healthcare and Family Services has mandated that MCOs use and not deviate from a standardized preferred drug formulary. HB 4096  amends the Public Aid Code to require that the State's preferred drug formulary would serve only as a minimum standard, not a restrictive list, thus allowing MCOs to provide stronger drug coverage if they chose.  Sent to the governor. 

To express your support for any of these bills, you can call the governor's office at 312-814-2121 or 217-782-0244, or send a message via https://www2.illinois.gov/gov/contactus/Pages/VoiceAnOpinion.aspx

 Some bills hit bumps in the road...
HB 5464 - Access to mental health treatment (Sponsor: Sara Feigenholtz).The bill sought to permit treatment for inpatient and outpatient mental health benefits along with substance abuse disorder treatment for the first 180 days per plan year when deemed medically necessary by the person's health care provider and without the need for prior authorization.  Status: Fiscal note filed. The sponsor's office believes the bill may be revisited next session after budgetary re-evalution.

HB 1592 - Banning subminimum wage for PwDs  (Sponsor: Theresa Mah). The bill have would phased out the practice of paying sub-minimum wages to people with disabilities working in Illinois' 124 "sheltered workshops."  Status: Stalled in committee. The Illinois Network of Centers for Independent Living, which helped draft the bill, reports sponsors are working on compromise language possibly base on the very successful Maryland model.

 Elsewhere in healthcare news
As healthcare watchers may be aware, the Virginia Senate approved Medicaid expansion on May 30, becoming the second state to do so since Trump took office. (Maine was the first.) Last week, however, Michigan lawmakers passed a work requirements bill that would also end that state's expansion if a waiver that raises premiums on some Medicaid beneficiaries does not receive federal approval.

Meanwhile, Arkansas,  rolled out work requirements June 1 for its Arkansas Works Medicaid expansion, which is credited with reducing the rate of uninsurance in the state by 50%.

And in what we thought was the biggest bombshell, the Trump Administration announced June 7 that the Dept. of Justice would not defend the ACA against the latest constitutional challenge brought by 20 red states. It is historically unusual for the DOJ not to defend an existing law.

A further bombshell exploded last Friday night, when House Republicans voted to take back $15.3 billion in previously authorized appropriations, including $7 billion from the Children's Health Insurance Program, via "rescission." These explainers from the Washington Post and  Kaiser Health News help us understand why we should not - or should - be worried.

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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