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Key Lessons from Health & Medicine’s Budget Forum

On January 15, 2016, Health & Medicine hosted a meeting of The Chicago Forum for Justice in forum proceedings notes as a reference guide for the forum’s content.

Our notes are written as a summary and while they can’t fully capture the presentations, videos of each of the five mini panels are available on the event webpage, as are slides from speakers who used them in their presentations. We thank CAN TV for recording, editing, and sharing videos of the forum, extending the potential impact of our panelists’ presentations.

We hope these notes will be useful for advocates and policymakers seeking to understand issues related to the budget, think about potential revenue solutions, and consider strategies, framing, and narratives likely to advance progress.  Health & Medicine will be convening a small group soon to review the forum proceedings and discuss next steps for our work on this critical area, which we’ll share on our website.

While the budget problems and solutions are more complex than this, here are some main points that have emerged for me from conversations and from the presentations and discussion at the conference:

  • Illinois lacks sufficient revenue, which represents a structural budget problem, priming the State to have recurring budget shortages and hampering our ability to provide Illinoisans with the public services they need and want, thus harming the health of the public, and disproportionately harming vulnerable communities.
  • The structural budget problems have several potential revenue solutions, including a progressive income tax structure and efforts to ensure corporations pay their fair share, both of which are more equitable than our current system and would better grow revenue in proportion to the size of Illinois’ economy.
  • State elected officials are collectively responsible for passing a budget and using a selection of revenue solutions that will help preserve and improve the vital health, social, and education programs and services that support people’s health and Illinois’ economy.  Inaction on the structural revenue shortages that Illinois faces is an unacceptable abdication of the governing duties our public officials share.

Of course, these salient points are based on a range of facts and history about Illinois’ taxes and budgets, beyond the scope of this post.  A significant amount of such relevant detail is covered in the forum proceedings notes, as well as the slides and videos on the event webpage (linked to above).

Also, related to this subject, Health & Medicine’s Executive Director, Margie Schaps, had two letters focused on Illinois’ budget published in the last couple of weeks:



Wesley Epplin
Director of Health Equity
Health & Medicine Policy Research Group

Halloween Marks a Scary Time for Health Care in Illinois


If things don’t change soon, health care could be in for major setbacks in Illinois. The State budget battle is approaching its fifth month and counting.  So far, Medicaid payments continue per court order, but other services are beginning to run out of money:

  • State payments to 911 call centers throughout the Illinois have been suspended, putting emergency services in jeopardy. 
  • Illinois has stopped paying medical and dental claims for 150,000 state employees. The long-term cost of delayed care for a group of this size could be far greater than the cost of paying for care and preventative care today. 
  • The state’s Psychiatric Leadership Capacity Grant, which was $27 million in the State’s FY2015 budget, is no longer being funded, affecting most of the 140 community health centers in Illinois and thousands of people who rely on them for psychiatric care. 
The longer the State budget impasse continues, the more services will be cut. These include services that indirectly have an impact on Illinois health care, such as after-school programs to keep kids out of trouble and supplemental nutrition programs, especially for the older adults.

It’s Not Too Late to Raise Your Voice!  

Contact your State legislators to let them know how concerned you are about the future of health care in Illinois. Tell them that Illinois seniors and children are especially vulnerable. We can’t let cuts affect them.Many program cuts will result in greater costs to the State in the not-so-long run. For example:
  • Home care services and home delivered meals to seniors citizens cost a fraction of the $75,000 annual cost of nursing home care. Cuts to these programs will mean more seniors ending up in nursing homes, paid for by Medicaid. 
  • Cut backs to after-school programs and Department of Children and Family Services support for older children will mean more kids and young adults intersecting with the justice system. Even short-term incarceration can pay for a full year of after-school activities for a child.
  • Cut backs to mental health services will only cause an increase in city and country jail populations where the State will not only have to provide mental health services, but food, clothing and shelter. 
And remind them that, as the State’s infrastructure crumbles and the State’s bond ratings tumble, it will only get more and more expensive to catch up.

Phillip Lanier
Health Policy Intern
Health & Disability Advocates

Update on SB 1194 (The Insurance Navigator Act)

Starting October 2013, an estimated 1.6 million Illinois residents will be eligible for new and affordable forms of public and private health insurance coverage under the Affordable Care Act. But the overwhelming majority of the newly eligible have no idea how to access these options. Many Illinoisans will need more information and guidance through the enrollment process.

The Affordable Care Act requires each state’s Health Insurance Marketplace to establish a Navigator Program that will guide these individuals through their new coverage and enrollment options. These Navigators will serve an important role in ensuring that individuals benefit from the ACA.

On January 30th, the potential efficacy of the Navigator program was threatened by the introduction of Illinois Senate Bill 1194, which would create overly restrictive criteria for organizations applying for and performing navigator functions.

Here are the issues with SB1194 (as it was introduced):

  • SB1194 placed unnecessary restrictions on Illinois Navigators and In-Person Assistors, making it more difficult for low-income and hard-to-reach populations to connect to the application assistance that they need.  
  • Illinois is currently preparing a Navigator training and oversight system that makes SB 1194 unnecessary. 
  • Federal law already mandates some of what is outlined in SB1194, such as prohibiting Navigators from recommending specific insurance products. Once again, SB1194 is unnecessary.  
  • Language in SB1194 prohibited Navigators from facilitating enrollment in a Federally Qualified Health Plan, (QHP), one of the five Navigator duties already specified by the ACA.
Consumer advocates and community based-providers recognized these issues, and successfully lobbied state Senators to make changes in the bill.

Here’s what changed:
  • SB1194 now includes the Navigator duties as spelled out in the ACA.
  • SB1194 now includes a certification, instead of a licensure, requirement.
  • SB1194 excludes all prior language that restricted Navigator duties, (such as the ability to facilitate enrollment in a QHP).
  • SB1194 is now in alignment with Federal regulations regarding the training and responsibilities of Navigators.
  • SB1194 now allows for the training of Certified Application Counselors, (another type of Navigator not directly compensated by the Exchange), to be defined at a later date. This means that CAC training will align with federal guidelines.
What’s happening now?

These amendments were filed on April 22nd, passed in the Senate on the 24th, and were referred to the House Rules Committee earlier today. You can follow SB 1194’s status here.Thanks to all of the advocates for raising your voices against restricting the navigators in this new health care system.

Nadeen Israel
Policy Associate, Heartland Alliance for Human Needs & Human Rights

Please contact Nadeen at nisrael@heartlandalliance.org for more information on SB1194.




A New Year and New Medicaid Awaits Us


What an amazing and historic beginning to the start of 2013. This week an Illinois legislative body advanced a major piece of the Affordable Care Act (ACA), when the House Human Services Appropriation Committee passed HB 6253, Medicaid Financing for the Uninsured.

After the committee vote, the waning hours of the current term of the General Assembly did not provide enough time to advance the bill further. Nevertheless, our momentum continues with renewed commitment and excitement.

This effort brought together an unusual mixture of health care providers, business interests, patients and advocates, demonstrating as great a degree of consensus on an issue like this as you are likely ever to find. We know it is right and advantageous for Illinois to accept new federal Medicaid funding, fill a historic gap in the Medicaid program and provide health care coverage for hundreds of thousands of the lowest income uninsured Illinois residents.

The fight continues and we have laid the scaffolding for us to build upon as we enter the 98th General Assembly today. Illinois House and Senate members will file new Medicaid bills, and once the new General Assembly begins, your voices will need to be heard again with in-district meetings, emails and phone calls to your Senators and Representatives, many of whom will be new in office or serving from redrawn districts. It will be critical that these legislators hear from you.

Thank you for all you have done. And thank you, in advance, for all the help you will provide in helping to achieve federal Medicaid funding for the uninsured in Illinois.

Ramon Gardenhire
Director of Government Relations
AIDS Foundation of Chicago

Start Your Week Right! Contact Springfield Today.





 
Leveraging Federal Financing for the Uninsured (HB 6253) Reaches the Illinois House THIS WEEK!
This week (and possibly TODAY)  the Illinois House will consider HB 6253 House Amendment 1 (HA 1), a bill to leverage federal financing of the state’s Medicaid program in 2014 to cover the uninsured, made eligible by the Affordable Care Act (ACA).

In Illinois today, thousands of low-income adults without dependent children are not eligible for Medicaid. This major gap in healthcare coverage would be eliminated by HB 6253 under the ACA. This Medicaid option is expected to bring $4.6 billion additional federal dollars into the state of Illinois just in the first three years, making it a great fiscal deal for Illinois!

HB 6253 authorizes Illinois to take advantage of the ACA to provide Medicaid to about 342,000 low-income Illinois citizens who are currently uninsured. Because of the ACA, Illinois can offer Medicaid to this population at no expense to the state for the first three years, and in later years the state will never pay more than 10% of the cost of this coverage (with federal funds covering the remaining 90%). Learn more about HB 6253 HA1.

2 Ways to Take Action TODAY:
  1. Tell your Illinois Representative to support HB 6253 today! Call the easy and toll-free ‘Illinois Affordable Health Care Hotline’ 1-888-616-3322 to be connected to your legislator. Need some talking points? Click here.  You can also look up your Illinois Representative’s contact information directly using this easy online tool!  Click here.
  2. Submit an electronic witness slip in favor of the bill: You can click here to file an electronic witness slip today.  Click on the icon on the right of the Appropriations committee to find the listing for HB 6253. Once you find HB 6253, click on “Create Witness Slip.” You should check the “proponent” box for House Amendment #1 (HA #1) and the “Record of Appearance Only” box.

*The 'Illinois Affordable Health Care Hotline’ is a function of the AARP Hotline. Please, do not be alarmed by the AARP phone recording. This phone line is open to everyone.
*The original House bill number (HB 5019) has changed since the recording of the Hotline to HB 6253, and may change again! Please, do not be alarmed by the incorrect bill number. This phone line is still active to support 'Medicaid Financing for the Uninsured'.
Thank you!

Questions? Contact Stephani Becker (312.265.9072) or Stephanie Altman (312.265.9070) at HDA.