Gov. Pritzker Signs Medicaid Omnibus Legislation That Increases Access And Equity In Illinois’ Health Care System

CHICAGO — Governor Pritzker signed a Medicaid omnibus (HB4343) today that includes a range of measures aimed at increasing access to quality health care services, preserving existing health care coverage, and continuing to create a more equitable health care system in Illinois. The legislation would provide continuous eligibility for adults enrolled in Medicaid, increase reimbursement rates for prenatal and postpartum health care coverage, and expand equity in coverage.

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“This legislation sends a clear message: in Illinois, healthcare is a right—not a privilege,” said Governor JB Pritzker. “Throughout my administration, it has been our priority to create the most equitable healthcare system in the nation. Today, we continue to make that idea a reality. I am proud to sign this bill into law to ensure that all Illinoisans have access to quality healthcare no matter their gender, race, age, or zip code.”

“As chair of the Council on Women and Girls, we know we must do more to erase all healthcare inequities, especially gender-based barriers that pose unique challenges,” said Lt. Governor Juliana Stratton. “By increasing reimbursement rates for critical prenatal and postpartum care, and more, this legislation puts people first and protects their right to quality healthcare services.”

“We consider it our mission every day to improve the lives of people across Illinois by increasing access and removing barriers to reaching quality health care options and maintaining a strong focus on equity in health care,” said Department of Healthcare and Family Services Director Theresa Eagleson. “This legislation takes significant steps to improve access and equity, maintain coverage for existing Medicaid customers and cover new services.”

Continuous eligibility

HFS will seek federal approval to implement 12 months of continuous eligibility for adults who are enrolled in the medical assistance program, which would allow adults to stay enrolled regardless of changes in income or household size.

The Department will also seek federal approval to allow individuals without a source of income at the time of their medical benefits redetermination to be considered for ex-parte renewal.

The Department will be required to report on a monthly basis the percentage of individuals whose eligibility was renewed through the ex-parte redetermination process.

“Implementing 12 months of continuous eligibility for adults will mean more consistency in access to health care services for Illinois residents enrolled in the Medicaid program,” said House Majority Leader Greg Harris (D-Chicago). “This is another important way we can remove barriers that stand between Illinois families and the health care services they need.”

Prenatal and postpartum health care coverage

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In addition to increasing prenatal and postpartum reimbursement rates, the legislation also expands coverage for midwifery services under the Medicaid program by adding Certified Professional Midwife services, effective January 1, 2023. Certified Nurse Midwife services are already covered under Medicaid.

“Expanding coverage for midwifery services under the Medicaid program will ensure that all women have access to compassionate and skilled care at a critical time,” said Rep. Robyn Gabel (D-Evanston). “This will mean that more women in Illinois will have someone to help advocate for them and achieve the delivery they want, and that there will be an additional layer of care if complications arise, and a better opportunity for good maternal health outcomes.”

Health Benefits for Immigrant Adults

The legislation expands eligibility for Illinois’ Health Benefits for Immigrant Adults (HBIA) program, which currently serves people aged 55 to 64. As of July 1, undocumented immigrant adults and lawful permanent residents who are in the five-year waiting period, and who would qualify for Medicaid if not for their immigration status, will be eligible for the program beginning at age 42.

The Health Benefits for Immigrant Seniors (HBIS) program provides health care coverage to undocumented immigrants and lawful permanent residents who are in the five-year waiting period aged 65 and older if they would qualify for the Medicaid program but for their immigration status. When Illinois launched the Health Benefits for Immigrant Seniors program in late 2020, it became the first state in the nation to offer this type of coverage, leading other states to follow suit.

“Everyone deserves access to quality health care services, and the Health Benefits for Immigrant Adults program expanding coverage to a larger population is another significant step toward more equity in health care,” said Rep. Delia Ramirez (D-Chicago.) “I’m proud that Illinois continues to be a leader in this area, and we will continue working to create an environment in this state where people can build long, healthy lives, regardless of their immigration status.”

These state programs provide health benefits to qualifying noncitizen adults, which are similar to the Medicaid benefits offered to citizens through the Medicaid program. The Health Benefits for Immigrant Adults and Health Benefits for Immigrant Seniors programs are entirely state-funded, as there are no federal matching funds available for these programs.

Other provisions

The legislation also provides for acupuncture for pain management, which is a newly covered service for Medicaid customers in Illinois, and increases the Medicaid Community Spouse Resource Allowance, which provides financial assistance to individuals whose spouse resides in a long-term care facility.

“Coverage for acupuncture services is going to make a major difference in the quality of life for people who live with chronic pain,” said Rep. Theresa Mah (D-Chicago). “I am so pleased that this provision, and the many other vital health care items this legislation includes will contribute to a stronger, more accessible and more equitable health care system in Illinois.”

Other bill provisions include:

  • Medi-Car rate increase to incentivize provider participation and address the current shortage of transportation options, an issue that is especially affecting Medicaid customers who need pickup from residential settings.
  • Mental health wellness checks in schools.
  • Certified Nursing Assistance (CNA) Internship Program to build staff for all care options.
  • $10 million dental rate increase targeting preventative services.
  • Seeking federal approval to cover new Peer Support Recovery specialists as a part of substance use disorder treatment.
  • Rate increase for external cephalic version rates (ECVs) to discourage the use of unnecessary caesarean sections.

Read More:

Jul 6, 2021 | Gov. Pritzker Signs Legislation Making Healthcare More Accessible And Affordable For Illinoisans

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Apr 27, 2021 | Gov. Pritzker Signs Equity Driven Healthcare Reform Legislation

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