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| [ Introduced ] | [ House Amendment 001 ] |
91_HB2677eng HB2677 Engrossed LRB9102968SMdv 1 AN ACT to provide for access to health coverage for 2 certain uninsured low income residents of the State of 3 Illinois. 4 Be it enacted by the People of the State of Illinois, 5 represented in the General Assembly: 6 Section 1. Short title. This Act may be cited as the Low 7 Income Uninsured Health Coverage Act. 8 Section 5. Legislative intent. The General Assembly finds 9 that, for the economic and social benefit of all citizens of 10 the State, it is important to enable low-income residents of 11 this State, to the extent funding permits, to access health 12 care coverage, especially for preventive health care. The 13 General Assembly recognizes that assistance to help low 14 income individuals and families purchase health care coverage 15 is essential in helping them transition from a health care 16 system where government partners with families to provide 17 health benefits to a system where individuals and families 18 with higher incomes eventually transition into private or 19 employer based health plans. This Act is not intended to 20 create an entitlement. 21 Section 10. Definitions. As used in this Act: 22 "Department" means the Illinois Department of Public Aid. 23 "Director" means the Director of Public Aid. 24 "Health care coverage" means a demonstration project that 25 provides a specific package of health care services to 26 eligible persons utilizing a combination of donated in-kind 27 services and services purchased with funding from a variety 28 of sources including public and private sources and patient 29 co-payments. The package of services need not be identical 30 to the benefits provided under the State's approved plan HB2677 Engrossed -2- LRB9102968SMdv 1 under Title XIX of the Social Security Act. The 2 demonstration projects shall be exempt from regulation by the 3 Department of Insurance as though they were directly operated 4 by the Department of Public Aid. 5 "Low income" means a resident with a pro-rata annual 6 family income under 200% of the Federal Poverty Level for the 7 family size. 8 "Resident" means a person who meets the residency 9 requirements as defined in Section 5-3 of the Illinois Public 10 Aid Code. 11 "Uninsured" means a resident who: 12 (1) does not have at the time of application and has not 13 had, for a period of 30 days prior to application, health 14 insurance through another source; and 15 (2) is not eligible for any other health insurance 16 program including KidCare, Medicaid, Medicare, Veteran's 17 Administration insurance, Workers' Compensation, employer 18 sponsored insurance, and others. 19 (3) a person who is otherwise eligible under this Act 20 shall be considered uninsured if that person has access to 21 employer sponsored or other health insurance, but the cost to 22 the employee is greater than 10% of his or her adjusted 23 taxable income. 24 Section 15. Operation of the Program. There is hereby 25 created a program to provide for grants to at least 5 26 communities around the State for development of demonstration 27 projects providing access to health care coverage for low 28 income uninsured residents of the State of Illinois. The 29 Program shall operate subject to appropriation and shall be 30 administered by the Department. The Department shall have 31 the powers and authority granted to the Department under the 32 Illinois Public Aid Code. 33 The necessary funds for the demonstration projects and HB2677 Engrossed -3- LRB9102968SMdv 1 for full implementation will be obtained from the settlement 2 of the litigation against the tobacco industry or from such 3 sums as may become available through other means. 4 Section 20. Plan for health care coverage for low income 5 uninsured residents. By the end of the demonstration period, 6 the Governor shall submit to the General Assembly a plan for 7 providing for the health insurance needs of low income, 8 uninsured residents of the State of Illinois. The plan shall 9 include a description of how the proposed plan for the low 10 income uninsured will integrate with the existing programs 11 operated under Title XIX (Medicaid) and Title XXI (KidCare) 12 of the Social Security Act, as amended, as well as a 13 description of how the proposed plan will cover those 14 individuals eligible for services from units of local 15 government pursuant to Article VI of the Illinois Public Aid 16 Code. 17 Section 25. Eligible applicants. Eligible applicants for 18 such projects may include: 19 (1) Local health departments. 20 (2) Not for profit corporations, including those formed 21 for the express purpose of providing health care for the 22 low-income uninsured. 23 (3) Health care providers and consortia of providers. 24 (4) Other organizations subject to the approval of the 25 Director. 26 Section 30. Criteria for selection. The Director shall 27 ensure, to the extent feasible, that the selected projects: 28 (1) Build on existing assets including relationships 29 with physicians and other providers who are willing to help. 30 (2) Include continuity of care and an array of services 31 appropriate for the population. HB2677 Engrossed -4- LRB9102968SMdv 1 (3) Include a cost-effective package of services 2 including prevention, consumer education, and care 3 management. The package of services may or may not include 4 the services included in the State Medicaid Plan. 5 (4) Contribute toward building a system of care. 6 (5) Describe how the plan will include cost sharing by 7 patients. 8 (6) Allow small employers to purchase coverage at 9 reasonable rates and minimize disincentives for employers to 10 provide coverage. 11 (7) Provide services that are reasonably accessible in 12 terms of time and place. 13 (8) Optimize assets, both money and in kind. 14 (9) Shift location of services from services provided in 15 a high cost setting to services provided in a cost efficient 16 manner. 17 (10) Demonstrate involvement in planning of potential 18 consumers, providers of health care, employers, local health 19 departments, and local government. 20 (11) Provide high quality services. 21 (12) Include a variety of public and private sources of 22 funding. 23 (13) Represent a variety of communities around the State 24 that are broadly representative of the communities in the 25 State, in terms of location, population, size, diversity, and 26 access to health care. 27 Section 35. Funding for projects. Each approved 28 demonstration project shall receive funding for a one year 29 planning phase and, subject to the Director's approval of a 30 satisfactory plan, for a 3 year implementation phase, not to 31 exceed $100,000 for the planning phase and $250,000 per year 32 for the implementation phase. The health coverage provided 33 by the demonstration projects to be developed with the funds HB2677 Engrossed -5- LRB9102968SMdv 1 appropriated for the purposes of this Act is not an 2 entitlement and shall not be construed to create an 3 entitlement. 4 Section 40. Waivers. The Department shall request any 5 necessary waivers of federal requirements in order to allow 6 receipt of federal funding to provide funding for the 7 services to be developed under this Act, or for the services 8 to be described under the statewide plan to be developed 9 under this Act. 10 Section 50. Program evaluation. During this 11 demonstration period, the Department is charged with 12 monitoring and evaluating the results of the 5 pilots and any 13 other ongoing models that may exist within the State. 14 Section 99. Effective date. This Act takes effect upon 15 becoming law.