Capitol Fax.com - Your Illinois News Radar » *** UPDATED x1 *** Pritzker administration announces some “temporary” enrollment limits, co-pays to hold down undocumented immigrant healthcare costs
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*** UPDATED x1 *** Pritzker administration announces some “temporary” enrollment limits, co-pays to hold down undocumented immigrant healthcare costs

Friday, Jun 16, 2023 - Posted by Rich Miller

* As you are certainly aware, the governor told the General Assembly he needed legislative authority to use specific “tools” to rein in costs of the healthcare program for undocumented immigrants. The administration claimed that costs would rise $1.1 billion next fiscal year without intervention. The idea is to keep the increase to half that amount.

Limiting enrollment and establishing co-pays were two of those tools, and they’re being announced today. In two weeks, enrollment will be limited for the Health Benefits for Immigrant Adults program, which applies to people 42-64. The 65+ population will not yet be limited. From HFS

The Illinois Department of Healthcare and Family Services (the Department) is providing public notice that enrollment in the Health Benefits for Immigrant Adults (HBIA) program will be temporarily paused effective July 1, 2023. This action is being taken through emergency rulemaking, under the authority recently granted to the Department by the Illinois General Assembly in SB 1298, to ensure the program does not exceed the funds available and appropriated in the Fiscal Year 2024 (FY24) Budget.

Anyone who is already enrolled in and remains eligible for coverage through the HBIA program will continue to be covered. Enrollment in the Health Benefits for Immigrant Seniors (HBIS) program will remain open at this time.

The emergency rules allowing the Department to close or open enrollment with no later than 14 days calendar notice can be viewed at https://hfs.illinois.gov/info/legal/publicnotices.html. Other program adjustments within the emergency rules to keep HBIA and HBIS program costs from exceeding funds available and appropriated in the FY24 Budget are described below.

Beginning July 1, 2023, providers may collect co-payments and cost sharing on the following services when they do not qualify for federal match under the Emergency Medical for Noncitizens program:

    • Inpatient hospitalizations: $250 co-pay
    • Hospital emergency room visits: $100 co-pay
    • Hospital or Ambulatory Surgical Treatment Center outpatient services set forth at 89 Ill. Adm. Code 148.140(b): 10% of the Department rate

Any large public hospitals, as defined in Section 148.25(a), having received payments in excess of the rates paid to non-large public hospitals shall be required to reimburse the state for any excess payment in a method and amount determined by the Department.

The Department may limit or eliminate backdated medical coverage to keep the cost of the HBIA and HBIS program within the funds available and appropriated.

Thoughts?

…Adding… From HFS…

At this time, enrollment in the Health Benefits for Immigrant Seniors program will remain open. However, HBIS enrollment will be temporarily paused for FY24 if the number of individuals enrolled in the program reaches 16,500.

Anyone who is already enrolled in and remains eligible for coverage through the HBIA and HBIS programs will continue to be covered. The Department will not be removing any current enrollees who remain eligible for this coverage, and hopes to resume new enrollments as soon as fiscally possible.

The enrollment changes are necessary to bring program costs within the budgeted amount for State Fiscal Year 2024, which begins July 1. Compared with the traditional Medicaid population, month-over-month enrollment has grown at a higher rate, and per-enrollee costs have tracked higher among the HBIA and HBIS-enrolled populations due to more prevalent, untreated chronic conditions and higher hospital costs.

HFS understands that this program is a vital resource for individuals who would otherwise be eligible for Medicaid but for their immigration status. The Department understands the importance of preserving this nation-leading program for the future. […]

Prior to determining cost-containment actions, HFS sought to maximize available funds for these programs, and will utilize the following to enhance revenues:

    • Pursuing methodology to maximize federal reimbursement for emergency medical expenses.
    • Pursuing supplemental prescription drug rebates for the covered noncitizen population.
    • Transitioning HBIA and HBIS program enrollees to the Medicaid Managed Care program starting January 1, 2024, which will generate additional dollars to fund the programs through taxes the Department collects from the Medicaid Managed Care Organizations.
    • Addressing current overpayments to the Cook County Hospital System.

Managed care was another tool discussed.

And Cook County was receiving the same enhanced match it gets for regular Medicaid. Looks like they’re gonna try to claw that back.

*** UPDATE *** Latino Caucus…

The Illinois Legislative Latino Caucus released the following statement Friday in response to the announcement that the state’s Health Benefits for Immigrant Adults program will freeze enrollment July 1 for noncitizens age 42 to 64:

“In 2020, we made history by becoming the first state to offer health care coverage to certain noncitizen age groups. We knew that when the COVID-19 pandemic hit, Latino communities were among the most vulnerable, and we stepped up to lay the foundation for a program that would make sure every Illinois resident could get the care they needed.

“This announcement is disappointing but is also a call to action. Come July 1, noncitizen adults will no longer be able to sign up for new health care coverage. This means that noncitizens age 42 to 64 need to enroll now, before July 1, if they have not already. Seniors age 65 or older will still be able to enroll after July 1.

“As we pride ourselves as being a welcoming state, we should not be cutting health benefits and creating barriers to healthcare.”

“We acknowledge the progress we have made in securing resources for noncitizens in recent years. We were proud to fight to make Illinois the first state in the nation to offer Medicaid-like benefits to these communities. However, this backslide is disappointing.

“We will continue to fight for health care for all Illinoisans. Latino Caucus members have not given up – and will pursue closing the gap in coverage until we achieve health care for all residents. The often-disenfranchised communities we represent sent us to Springfield to be their voice; we will never turn our backs on them.”

…Adding… Healthy Illinois Campaign…

Today, the Illinois Department of Healthcare and Family Services published notice that enrollment will be paused for healthcare coverage for Illinois immigrants ages 42-64 under the Health Benefits for Immigrant Adults (HBIA) program. The notices also authorize a host of other changes to the program including co-pays and reduced hospital reimbursements.

Healthy Illinois strongly condemns the decision and calls on Governor Pritzker to reverse his decision immediately and work in good faith with advocates and members of the Illinois General Assembly to ensure that healthcare truly is a right, not a privilege in our state.

By slashing live-saving health coverage for Illinois immigrants, Governor Pritzker is turning his back on the communities he claims Illinois welcomes and aligning himself with anti-immigrant Republicans around the country.

Because of Governor Pritzker’s decision, there are people who will be forced to forgo cancer treatment, diabetes care, mental health care, and countless other kinds of necessary medical treatment. Today’s move is immoral and fiscally short-sighted, as Governor Prizker himself said just last week “We save money when we invest in healthcare for undocumented immigrants…If they don’t get basic healthcare, they end up in an emergency room and we all end up paying for that at a much highest cost than if we have regular care and preventative care for people.”

If you are aged 42 or older and believe you may qualify for health coverage, regardless of your immigration status, apply immediately at https://abe.illinois.gov/abe/access/.

Illinois made history in 2020 and set national precedent when we became the first state to expand coverage to low-income seniors regardless of immigration status. Today, we took a massive step backward by passing anti-immigrant, anti-public health, unjust administrative rules.

       

2 Comments
  1. - Candy Dogood - Friday, Jun 16, 23 @ 2:02 pm:

    ===$1.1 billion next fiscal year without intervention===

    From what I have been hearing it sounds like Governor Pritzker is planning or at least trying to passing the cost of this program on to state and university employees.


  2. - Rich Miller - Friday, Jun 16, 23 @ 2:03 pm:

    ===From what I have been hearing===

    lol

    Not sure what to say about that, other than maybe he wants to free up some money spent on insurance for said workers.


Sorry, comments for this post are now closed.


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