Health Care Reform Bill will Head to Governor
A massive health care reform bill, the fourth and final pillar of the Illinois Legislative Black Caucus agenda, passed the state Senate Thursday, the final step before heading to Gov. JB Pritzker for his signature.
House Bill 158, sponsored by Democratic Rep. Camille Lilly and state Sen. Mattie Hunter, both of Chicago, is centered around eliminating race-based and other inequities in the state’s health care system, and includes provisions to expand medical services available to low-income residents and residents of color.
Specifically, HB 158 addresses access to health care, hospital closures, managed care organization reform, community health worker certification and reimbursement, maternal and infant mortality, mental and substance abuse treatment, and medical implicit bias.
“For Black lives to truly matter, their right to quality health care must (not) be inhibited,” Hunter said in Senate floor debate. “It is our responsibility as elected officials to create laws that create an enriched, lasting impact on the communities we represent. This legislation does just that, and there is no better time to enact than now.”
The bill passed on a 41-16 vote after revisions to the original version, which failed to pass in January’s lame duck session.
The new version eliminated provisions that would have replaced the state’s Medicaid managed care program with a standard fee-for-service payment system. Managed care, which is a system of private insurance companies hired by the state to manage Medicaid, is how a majority of the state’s residents on Medicaid are enrolled in the program.
A last-minute amendment, which enhanced dementia training requirements for the Illinois Department on Aging, was also added before the bill went for a full vote in the House last week. It passed the House with a 72-41 vote.
Most of the items included in the bill are subject to state appropriation, meaning future General Assemblies will have to decide whether to allocate the money to fund them.
House and Senate Republicans shared concerns about the total cost of implementing this legislation. In the Senate floor debate, Republican Sen. Steve McClure, of Springfield, said he doesn’t believe the state can afford to implement all the provisions in the bill
“The fiscal impact of $12 billion would represent almost 30 percent of the Governor's proposed fiscal year 2022 general funds budget, which is $41.6 billion,” McClure said. “We just can't afford it and that's really what it comes down to. And the $7.5 billion from the recent stimulus is going to help us quite a bit, but we're still in very rough financial shape right now.”
Democratic Sen. Jacqueline Collins, of Chicago, questioned how a price tag can be put on somebody’s life.
Another significant provision in the bill would put a halt on hospital closures for up to 60 days after the effective date of the act, which is an effort to prevent hospital closures in the immediate aftermath of the pandemic. Closures are also deferred until either the state or U.S. are no longer under disaster declaration or public health emergency.
“In the last year, we’ve seen thousands of deaths due to COVID-19. We’ve also seen how racism has intensified the effects of this pandemic on Black Illinoisans, and it’s time to take action against the factors that led us here,” Hunter said in a news release. “This groundbreaking initiative will give everyone the opportunity to receive equitable, patient-centered care, regardless of race or socioeconomic status.”
HB 158 would also create a Health and Human Services Taskforce and an Anti-Racism Commission to make recommendations for tangible solutions to be enacted by hospitals, health care organizations and the General Assembly as the conversation and analysis of racial inequities in the health care system continue.
HB 158 needs only the governor’s signature to become law after it passed both the House and Senate. It’s the final of four pillars of the ILBC’s legislative agenda introduced last year.
The other pillars of the ILBC agenda, which address economic equity, public safety and education, were also introduced in January’s lame duck session. These three pillars passed out of the lame duck session and have all been signed into law by the governor.
Pritzker released a statement lauding the effort Thursday night.
“For too long, our healthcare system has left behind Black and brown communities creating disparities in health outcomes. But today, here in Illinois, our legislature has passed a remarkable piece of legislation to build a healthier future for all of our communities," he said in the statement. "From standing up a process to certify and train community health workers, to funding new services like doulas and home visiting, to increasing oversight and transparency around Medicaid managed care system for its customers, this bill roots out racism from our healthcare system and state government – a cause I’m proud to advance. I want to congratulate Senator Hunter and Representative Lilly on bringing the Illinois Health Care and Human Services Reform Act to the finish line as well as Leader Lightford for her transformational leadership passing all pillars of the Illinois Legislative Black Caucus’ agenda. I’m proud to be your partner in shaping the Illinois our residents deserve.”
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