Trump/Ryan and Rauner Healthcare and Medicaid Proposals, Insurance Reform and Trans Issues

Last week I held hearings on how Donald Trump and Speaker Ryan’s plan to repeal and replace the ACA would affect Illinois.  President Trump is infamously known for declaring he never knew healthcare was so complicated. It is….and his legislation now being fast tracked through Congress with have enormous impact on our state and add new hardships for over 1 million people in out our state.


In Illinois we stand to lose $40 billion dollars in federal funds to support our Medicaid program which would cut or reduce healthcare for 1 in 4 Illinoisans, and almost half our children.  Such major cuts would have a cascading effect across our entire state healthcare system, putting the financial viability of several hospitals, healthcare systems, mental health and substance abuse providers and nursing homes at risk.


Individual families are also at enormous risk in Illinois.  According to the non-partisan Congressional Budget Office (CBO), the current Trump/Ryan plan would

  • cause 301,600 Illinoisans to lose employer-sponsored health insurance,
  • would cut off coverage for 55,000 elderly,
  • cut 62,000 from the insurance exchanges,
  • cut coverage for 975,700 Medicaid clients. Altogether this would mean over 1.3 million Illinoisans would lose health insurance as Trump/Ryan took effect


In addition here is a very short summary of some of the Trump/Ryan proposals other parts:


    • Loss of coverage for 24 million people (nationally)
    • Established new higher premiums for senior citizens
    • Repeals ability of states to use presumptive eligibility determinations for the disabled
    • Repeals the 6% bonus match for community-based attendant services and supports
    • Limits retrospective Medicaid Coverage
    • Repeals the option and enhanced match for newly eligible on 12/31/19
    • Institutes per-capita cap for states based on FY16 base year starting in FY20 (we are currently approaching FY18).
    • Imposes 30% insurance premium penalties for a year for people whose insurance lapses for more than 63 days
    • Repeals the actuarial value standards for the ACA
    • Provides new tax breaks for people earning over $1 million per year ($165 Billion in new tax cuts to the wealthiest!)
    • Provides new tax breaks for insurance company CEO compensation


Rauner Plan to Privatize Medicaid


While President Trump and Speaker Ryan push their plans in Washington, Governor Rauner is implementing a plan in Illinois to privatize the Medicaid program. The State has issued an RFP for the largest procurement in Illinois history, giving $9 billion in taxpayer dollars to big insurance companies. Besides being the largest contract ever granted in Illinois, it also bypasses the traditional checks and balances of the Procurement Code.   Watch this short video for more of my thoughts on this:


My New Law to Protect Consumers Health Insurance Rights


All the turmoil in the health insurance market has created enormous new problems for families looking to choose an affordable plan with reasonable premiums and out-of-pocket expenses, which also includes their choice of doctor, hospital, as well as in-network specialists for family members with complex diseases or serious chronic conditions.  Also, these doctors, hospitals and specialists should be within a reasonable travel time from the patient’s home.


All of my colleagues have seen a tremendous surge of constituent complaints in the last year or two from families who suddenly cannot find insurance plans that cover nearby doctors or hospitals, and if there are specialists for more serious or chronic diseases they may be in distant locations and not have open appointments for months.


Also, we have seen insurance plans change their provider networks in the middle of an insurance plan year.  Families who have carefully researched their insurance plan before they bought it to be sure that the doctors, hospitals and specialists that they need are in-network, suddenly find that they have been dropped from the network and there are no protections available to ensure continuity of care at in-network rates.


I am very happy to have worked with Assistant Republican Leader Chad Hays of Danville, IL to sponsor HB311, the Network Adequacy and Transparency Act.  This bill, which has 57 bipartisan sponsors from all regions of the state, passed out of the Insurance-Health & Life Committee last week with a unanimous vote.  The Illinois State Medical Society and the Illinois Health and Hospital Association have had the lead in crafting this bill, working in cooperation with individual insurance companies, the Director of the Illinois Department of Insurance, consumer healthcare advocates and patient advocates for chronic conditions such as cancer, HIV/AIDS, behavioral healthcare and others.


The law would require all plans to meet certain essential standards for travel times/distances to reach a healthcare provider, set standards for availability of doctors, hospitals and specialists. It would also require insurers and health plans to maintain accurate and up-to-date listings of in-network providers on their websites so that consumers can rely on accurate information when choosing a provider that their plan covers. It also sets standards for doctors and providers to regularly update insurers about changes of location, network participation, etc. to assist in the accuracy of information.


Importantly, this new law would include continuity of care provisions for patients who are undergoing treatment for serious or life-threatening illness, or women in the 3rd trimester of pregnancy so that their treatment is not interrupted and they will continue to be covered at in-network rates even if their healthcare provider is dropped from the insurers network during a plan year.  You can see the bill here:


Modernizing Birth Certificate Corrections for Transgender People


Also last week, my legislation to update the 50 year Illinois law governing how transgender people correct the gender marker on their birth certificates passed out of committee and now goes to the full house.  The legislation changes the half-century old medical standards to reflect the current standards of medical practice, as well as adding standards for intersex persons.  This also conforms Illinois law to the laws in many other states, as well as the requirements of Federal Agencies such as the Department of State and US Passport regulations.  Thanks to the ACLU, Lambda Legal, Trans-Life Center, Howard Brown Health Center, Equality Illinois, Illinois Safe Schools Alliance, the Illinois State Medical Society and all the others who participated in this effort. You can see the bill here: