Illinois General Assembly - Full Text of SB1041
Illinois General Assembly

  Bills & Resolutions  
  Compiled Statutes  
  Public Acts  
  Legislative Reports  
  IL Constitution  
  Legislative Guide  
  Legislative Glossary  

 Search By Number
 (example: HB0001)
Search Tips

Search By Keyword

Full Text of SB1041  102nd General Assembly

SB1041ham001 102ND GENERAL ASSEMBLY

Rep. Mary E. Flowers

Filed: 10/27/2021

 

 


 

 


 
10200SB1041ham001LRB102 04857 KTG 30261 a

1
AMENDMENT TO SENATE BILL 1041

2    AMENDMENT NO. ______. Amend Senate Bill 1041 by replacing
3everything after the enacting clause with the following:
 
4    "Section 1. Short title. This Act may be cited as the
5Consumer Choice in Maternal Care for African-American Mothers
6Program Act.
 
7    Section 5. Findings. The General Assembly finds the
8following:
9        (1) In its 2018 Illinois Maternal Morbidity and
10    Mortality Report, the Department of Public Health reported
11    that Black women were 6 times as likely to die from a
12    pregnancy-related condition as white women, and that in
13    Illinois, 72% of pregnancy-related deaths and 93% of
14    violent pregnancy-associated deaths were deemed
15    preventable.
16        (2) The Department of Public Health also found that

 

 

10200SB1041ham001- 2 -LRB102 04857 KTG 30261 a

1    between 2016 and 2017, Black women had the highest rate of
2    severe maternal morbidity with a rate of 101.5 per 10,000
3    deliveries, which is almost 3 times as high as the rate for
4    white women.
5        (3) In 2019, the Chicago Department of Public Health
6    released a data report on Maternal Morbidity and Mortality
7    in Chicago and found that "(w)omen for whom Medicaid was
8    the delivery payment source are significantly more likely
9    than those who used private insurance to experience severe
10    maternal morbidity." The Chicago Department of Public
11    Health identified zip codes within the city that had the
12    highest rates of severe maternal morbidity in 2016 and
13    2017 (100.4-172.8 per 10,000 deliveries). These zip codes
14    included: 60653, 60637, 60649, 60621, 60612, 60624, and
15    60644. All of the zip codes were identified as
16    experiencing high economic hardship. According to the
17    Chicago Department of Public Health "(c)hronic diseases,
18    including obesity, hypertension, and diabetes can increase
19    the risk of a woman experiencing adverse outcomes during
20    pregnancy." However, "there were no significant
21    differences in pre-pregnancy BMI, hypertension, and
22    diabetes between women who experienced a
23    pregnancy-associated death and all women who delivered
24    babies in Chicago."
25        (4) In a national representative survey sample of
26    mothers who gave birth in an American hospital in 2011 and

 

 

10200SB1041ham001- 3 -LRB102 04857 KTG 30261 a

1    2012, 1 out of 4 mothers who identified as Black or
2    African-American expressed that they would "definitely
3    want" to have a future birth at home, compared to 8.4% of
4    white mothers. Black mothers express a demand for planned
5    home birth services at almost 3 times the rate of white
6    mothers. Yet, in the United States, non-Hispanic white
7    women who can afford to pay out-of-pocket for their labor
8    and delivery costs access planned home birth care at the
9    greatest rate. Similarly, an analysis of birth certificate
10    data from the Centers for Disease Control and Prevention
11    for the years 2016 through 2019 shows that non-Hispanic
12    white mothers are 7 times more likely than non-Hispanic
13    Black mothers to experience a planned home birth.
14        (5) According to calculations based on birth
15    certificate data from July 2019 in Cook County, there
16    would have to be 7 Black or African-American certified
17    professional midwives working in Cook County in order for
18    just 1% of Black mothers in Cook County to have access to
19    racially concordant midwifery care in a given month.
20        (6) For birthing persons of sufficient health who
21    desire to give birth outside of an institutional setting
22    without the assistance of epidural analgesia, planned home
23    birth under the care of a certified professional midwife
24    can be a dignifying and safe, evidence-based choice. In
25    contrast, regulatory impingement on Black families'
26    ability to access that choice does not serve to enhance

 

 

10200SB1041ham001- 4 -LRB102 04857 KTG 30261 a

1    maternal or neonatal safety, but instead reifies the
2    institutionalization of Black bodies by the State.
3        (7) In order to make safe, planned home births
4    accessible to Black families in Illinois, the State must
5    require Medicaid provider networks to include certified
6    professional midwives. According to natality data from the
7    Centers for Disease Control and Prevention, every year
8    from 2016 through 2019, 2 out of every 3 live births to
9    Black or African-American mothers living in Cook County
10    utilized Medicaid as the source of payment for delivery.
11    According to that same data, Medicaid paid for over 14,000
12    deliveries to Black or African-American mothers residing
13    in Cook County during the year 2019 alone.
14        (8) A population-level, retrospective cohort study
15    published in 2018 that used province-wide maternity,
16    medical billing, and demographic data from British
17    Columbia, Canada concluded that antenatal midwifery care
18    in British Columbia was associated with lower odds of
19    small-for-gestational-age birth, preterm birth, and low
20    birth weight for women of low socioeconomic position
21    compared with physician models of care. Results support
22    the development of policy to ensure antenatal midwifery
23    care is available and accessible for women of low
24    socioeconomic position.
25        (9) In its January 2018 report to the General
26    Assembly, the Department of Healthcare and Family Services

 

 

10200SB1041ham001- 5 -LRB102 04857 KTG 30261 a

1    reported that its infant and maternal care expenditures in
2    calendar year 2015 totaled $1,410,000,000. The Department
3    of Healthcare and Family Services said, "(t)he majority of
4    HFS birth costs are for births with poor outcomes. Costs
5    for Medicaid covered births are increasing annually while
6    the number of covered births is decreasing for the same
7    period". The Department of Healthcare and Family Services'
8    expenditures average $12,000 per birth during calendar
9    year 2015 for births that did not involve poor outcomes
10    such as low birth weight, very low birth weight, and
11    infant mortality. That $12,000 expenditure covered
12    prenatal, intrapartum, and postpartum maternal healthcare,
13    as well as infant care through the first year of life. The
14    next least expensive category of births averaged an
15    expenditure of $40,200. The most expensive category of
16    births refers to births resulting in very low birth weight
17    which cost the Department of Healthcare and Family
18    Services over $328,000 per birth.
19        (10) Expanding Medicaid coverage to include perinatal
20    and intrapartum care by certified professional midwives
21    will not contribute to increased taxpayer burden and, in
22    fact, will likely decrease the Department of Healthcare
23    and Family Services' expenditures on maternal care while
24    improving maternal health outcomes within the Black
25    community in Illinois.
 

 

 

10200SB1041ham001- 6 -LRB102 04857 KTG 30261 a

1    Section 10. Medicaid voucher program. The Task Force on
2Infant and Maternal Mortality Among African Americans shall
3partner with Holistic Birth Collective to develop rules and
4regulations for a Medicaid voucher program to expand consumer
5choice for Black mothers that includes planned home birth
6services and in-home perinatal and postpartum care services
7provided by racially concordant nationally accredited
8certified professional midwives who are licensed and
9registered in Illinois. On January 1, 2024, and each January 1
10thereafter, the Task Force shall submit a report to the
11General Assembly that provides a status update on the program
12and annual impact measure reporting. The Department of Public
13Health, in consultation with the Department of Healthcare and
14Family Services, shall implement the program.
 
15    Section 15. Maternity episode payment model. The program
16shall implement a maternity episode payment model that
17provides a single payment for all services across the
18prenatal, intrapartum, and postnatal period which covers the 9
19months of pregnancy plus 12 weeks of postpartum. The core
20elements of the maternity care episode payment model shall
21include all of the following:
22        (1) Limited exclusion of selected high-cost health
23    conditions and further adjustments to limit service
24    provider risk such as risk adjustment and stop loss.
25        (2) Duration from the initial entry into prenatal care

 

 

10200SB1041ham001- 7 -LRB102 04857 KTG 30261 a

1    through the postpartum and newborn periods.
2        (3) Single payment for all services across the
3    episode.
4    The Department of Public Health, in consultation with the
5Department of Healthcare and Family Services, shall make
6available to the Task Force all relevant data related to
7maternal care expenditures made under the State's Medical
8Assistance Program so that budget-neutral reimbursement rates
9can be established for bundled maternal care services spanning
10the prenatal, labor and delivery, and postpartum phases of a
11maternity episode.
 
12    Section 90. The Illinois Public Aid Code is amended by
13changing Section 5-2 as follows:
 
14    (305 ILCS 5/5-2)  (from Ch. 23, par. 5-2)
15    Sec. 5-2. Classes of persons eligible. Medical assistance
16under this Article shall be available to any of the following
17classes of persons in respect to whom a plan for coverage has
18been submitted to the Governor by the Illinois Department and
19approved by him. If changes made in this Section 5-2 require
20federal approval, they shall not take effect until such
21approval has been received:
22        1. Recipients of basic maintenance grants under
23    Articles III and IV.
24        2. Beginning January 1, 2014, persons otherwise

 

 

10200SB1041ham001- 8 -LRB102 04857 KTG 30261 a

1    eligible for basic maintenance under Article III,
2    excluding any eligibility requirements that are
3    inconsistent with any federal law or federal regulation,
4    as interpreted by the U.S. Department of Health and Human
5    Services, but who fail to qualify thereunder on the basis
6    of need, and who have insufficient income and resources to
7    meet the costs of necessary medical care, including, but
8    not limited to, the following:
9            (a) All persons otherwise eligible for basic
10        maintenance under Article III but who fail to qualify
11        under that Article on the basis of need and who meet
12        either of the following requirements:
13                (i) their income, as determined by the
14            Illinois Department in accordance with any federal
15            requirements, is equal to or less than 100% of the
16            federal poverty level; or
17                (ii) their income, after the deduction of
18            costs incurred for medical care and for other
19            types of remedial care, is equal to or less than
20            100% of the federal poverty level.
21            (b) (Blank).
22        3. (Blank).
23        4. Persons not eligible under any of the preceding
24    paragraphs who fall sick, are injured, or die, not having
25    sufficient money, property or other resources to meet the
26    costs of necessary medical care or funeral and burial

 

 

10200SB1041ham001- 9 -LRB102 04857 KTG 30261 a

1    expenses.
2        5.(a) Beginning January 1, 2020, women during
3    pregnancy and during the 12-month period beginning on the
4    last day of the pregnancy, together with their infants,
5    whose income is at or below 200% of the federal poverty
6    level. Until September 30, 2019, or sooner if the
7    maintenance of effort requirements under the Patient
8    Protection and Affordable Care Act are eliminated or may
9    be waived before then, women during pregnancy and during
10    the 12-month period beginning on the last day of the
11    pregnancy, whose countable monthly income, after the
12    deduction of costs incurred for medical care and for other
13    types of remedial care as specified in administrative
14    rule, is equal to or less than the Medical Assistance-No
15    Grant(C) (MANG(C)) Income Standard in effect on April 1,
16    2013 as set forth in administrative rule.
17        (b) The plan for coverage shall provide ambulatory
18    prenatal care to pregnant women during a presumptive
19    eligibility period and establish an income eligibility
20    standard that is equal to 200% of the federal poverty
21    level, provided that costs incurred for medical care are
22    not taken into account in determining such income
23    eligibility.
24        (c) The Illinois Department may conduct a
25    demonstration in at least one county that will provide
26    medical assistance to pregnant women, together with their

 

 

10200SB1041ham001- 10 -LRB102 04857 KTG 30261 a

1    infants and children up to one year of age, where the
2    income eligibility standard is set up to 185% of the
3    nonfarm income official poverty line, as defined by the
4    federal Office of Management and Budget. The Illinois
5    Department shall seek and obtain necessary authorization
6    provided under federal law to implement such a
7    demonstration. Such demonstration may establish resource
8    standards that are not more restrictive than those
9    established under Article IV of this Code.
10        6. (a) Children younger than age 19 when countable
11    income is at or below 133% of the federal poverty level.
12    Until September 30, 2019, or sooner if the maintenance of
13    effort requirements under the Patient Protection and
14    Affordable Care Act are eliminated or may be waived before
15    then, children younger than age 19 whose countable monthly
16    income, after the deduction of costs incurred for medical
17    care and for other types of remedial care as specified in
18    administrative rule, is equal to or less than the Medical
19    Assistance-No Grant(C) (MANG(C)) Income Standard in effect
20    on April 1, 2013 as set forth in administrative rule.
21        (b) Children and youth who are under temporary custody
22    or guardianship of the Department of Children and Family
23    Services or who receive financial assistance in support of
24    an adoption or guardianship placement from the Department
25    of Children and Family Services.
26        7. (Blank).

 

 

10200SB1041ham001- 11 -LRB102 04857 KTG 30261 a

1        8. As required under federal law, persons who are
2    eligible for Transitional Medical Assistance as a result
3    of an increase in earnings or child or spousal support
4    received. The plan for coverage for this class of persons
5    shall:
6            (a) extend the medical assistance coverage to the
7        extent required by federal law; and
8            (b) offer persons who have initially received 6
9        months of the coverage provided in paragraph (a)
10        above, the option of receiving an additional 6 months
11        of coverage, subject to the following:
12                (i) such coverage shall be pursuant to
13            provisions of the federal Social Security Act;
14                (ii) such coverage shall include all services
15            covered under Illinois' State Medicaid Plan;
16                (iii) no premium shall be charged for such
17            coverage; and
18                (iv) such coverage shall be suspended in the
19            event of a person's failure without good cause to
20            file in a timely fashion reports required for this
21            coverage under the Social Security Act and
22            coverage shall be reinstated upon the filing of
23            such reports if the person remains otherwise
24            eligible.
25        9. Persons with acquired immunodeficiency syndrome
26    (AIDS) or with AIDS-related conditions with respect to

 

 

10200SB1041ham001- 12 -LRB102 04857 KTG 30261 a

1    whom there has been a determination that but for home or
2    community-based services such individuals would require
3    the level of care provided in an inpatient hospital,
4    skilled nursing facility or intermediate care facility the
5    cost of which is reimbursed under this Article. Assistance
6    shall be provided to such persons to the maximum extent
7    permitted under Title XIX of the Federal Social Security
8    Act.
9        10. Participants in the long-term care insurance
10    partnership program established under the Illinois
11    Long-Term Care Partnership Program Act who meet the
12    qualifications for protection of resources described in
13    Section 15 of that Act.
14        11. Persons with disabilities who are employed and
15    eligible for Medicaid, pursuant to Section
16    1902(a)(10)(A)(ii)(xv) of the Social Security Act, and,
17    subject to federal approval, persons with a medically
18    improved disability who are employed and eligible for
19    Medicaid pursuant to Section 1902(a)(10)(A)(ii)(xvi) of
20    the Social Security Act, as provided by the Illinois
21    Department by rule. In establishing eligibility standards
22    under this paragraph 11, the Department shall, subject to
23    federal approval:
24            (a) set the income eligibility standard at not
25        lower than 350% of the federal poverty level;
26            (b) exempt retirement accounts that the person

 

 

10200SB1041ham001- 13 -LRB102 04857 KTG 30261 a

1        cannot access without penalty before the age of 59
2        1/2, and medical savings accounts established pursuant
3        to 26 U.S.C. 220;
4            (c) allow non-exempt assets up to $25,000 as to
5        those assets accumulated during periods of eligibility
6        under this paragraph 11; and
7            (d) continue to apply subparagraphs (b) and (c) in
8        determining the eligibility of the person under this
9        Article even if the person loses eligibility under
10        this paragraph 11.
11        12. Subject to federal approval, persons who are
12    eligible for medical assistance coverage under applicable
13    provisions of the federal Social Security Act and the
14    federal Breast and Cervical Cancer Prevention and
15    Treatment Act of 2000. Those eligible persons are defined
16    to include, but not be limited to, the following persons:
17            (1) persons who have been screened for breast or
18        cervical cancer under the U.S. Centers for Disease
19        Control and Prevention Breast and Cervical Cancer
20        Program established under Title XV of the federal
21        Public Health Service Services Act in accordance with
22        the requirements of Section 1504 of that Act as
23        administered by the Illinois Department of Public
24        Health; and
25            (2) persons whose screenings under the above
26        program were funded in whole or in part by funds

 

 

10200SB1041ham001- 14 -LRB102 04857 KTG 30261 a

1        appropriated to the Illinois Department of Public
2        Health for breast or cervical cancer screening.
3        "Medical assistance" under this paragraph 12 shall be
4    identical to the benefits provided under the State's
5    approved plan under Title XIX of the Social Security Act.
6    The Department must request federal approval of the
7    coverage under this paragraph 12 within 30 days after July
8    3, 2001 (the effective date of Public Act 92-47) this
9    amendatory Act of the 92nd General Assembly.
10        In addition to the persons who are eligible for
11    medical assistance pursuant to subparagraphs (1) and (2)
12    of this paragraph 12, and to be paid from funds
13    appropriated to the Department for its medical programs,
14    any uninsured person as defined by the Department in rules
15    residing in Illinois who is younger than 65 years of age,
16    who has been screened for breast and cervical cancer in
17    accordance with standards and procedures adopted by the
18    Department of Public Health for screening, and who is
19    referred to the Department by the Department of Public
20    Health as being in need of treatment for breast or
21    cervical cancer is eligible for medical assistance
22    benefits that are consistent with the benefits provided to
23    those persons described in subparagraphs (1) and (2).
24    Medical assistance coverage for the persons who are
25    eligible under the preceding sentence is not dependent on
26    federal approval, but federal moneys may be used to pay

 

 

10200SB1041ham001- 15 -LRB102 04857 KTG 30261 a

1    for services provided under that coverage upon federal
2    approval.
3        13. Subject to appropriation and to federal approval,
4    persons living with HIV/AIDS who are not otherwise
5    eligible under this Article and who qualify for services
6    covered under Section 5-5.04 as provided by the Illinois
7    Department by rule.
8        14. Subject to the availability of funds for this
9    purpose, the Department may provide coverage under this
10    Article to persons who reside in Illinois who are not
11    eligible under any of the preceding paragraphs and who
12    meet the income guidelines of paragraph 2(a) of this
13    Section and (i) have an application for asylum pending
14    before the federal Department of Homeland Security or on
15    appeal before a court of competent jurisdiction and are
16    represented either by counsel or by an advocate accredited
17    by the federal Department of Homeland Security and
18    employed by a not-for-profit organization in regard to
19    that application or appeal, or (ii) are receiving services
20    through a federally funded torture treatment center.
21    Medical coverage under this paragraph 14 may be provided
22    for up to 24 continuous months from the initial
23    eligibility date so long as an individual continues to
24    satisfy the criteria of this paragraph 14. If an
25    individual has an appeal pending regarding an application
26    for asylum before the Department of Homeland Security,

 

 

10200SB1041ham001- 16 -LRB102 04857 KTG 30261 a

1    eligibility under this paragraph 14 may be extended until
2    a final decision is rendered on the appeal. The Department
3    may adopt rules governing the implementation of this
4    paragraph 14.
5        15. Family Care Eligibility.
6            (a) On and after July 1, 2012, a parent or other
7        caretaker relative who is 19 years of age or older when
8        countable income is at or below 133% of the federal
9        poverty level. A person may not spend down to become
10        eligible under this paragraph 15.
11            (b) Eligibility shall be reviewed annually.
12            (c) (Blank).
13            (d) (Blank).
14            (e) (Blank).
15            (f) (Blank).
16            (g) (Blank).
17            (h) (Blank).
18            (i) Following termination of an individual's
19        coverage under this paragraph 15, the individual must
20        be determined eligible before the person can be
21        re-enrolled.
22        16. Subject to appropriation, uninsured persons who
23    are not otherwise eligible under this Section who have
24    been certified and referred by the Department of Public
25    Health as having been screened and found to need
26    diagnostic evaluation or treatment, or both diagnostic

 

 

10200SB1041ham001- 17 -LRB102 04857 KTG 30261 a

1    evaluation and treatment, for prostate or testicular
2    cancer. For the purposes of this paragraph 16, uninsured
3    persons are those who do not have creditable coverage, as
4    defined under the Health Insurance Portability and
5    Accountability Act, or have otherwise exhausted any
6    insurance benefits they may have had, for prostate or
7    testicular cancer diagnostic evaluation or treatment, or
8    both diagnostic evaluation and treatment. To be eligible,
9    a person must furnish a Social Security number. A person's
10    assets are exempt from consideration in determining
11    eligibility under this paragraph 16. Such persons shall be
12    eligible for medical assistance under this paragraph 16
13    for so long as they need treatment for the cancer. A person
14    shall be considered to need treatment if, in the opinion
15    of the person's treating physician, the person requires
16    therapy directed toward cure or palliation of prostate or
17    testicular cancer, including recurrent metastatic cancer
18    that is a known or presumed complication of prostate or
19    testicular cancer and complications resulting from the
20    treatment modalities themselves. Persons who require only
21    routine monitoring services are not considered to need
22    treatment. "Medical assistance" under this paragraph 16
23    shall be identical to the benefits provided under the
24    State's approved plan under Title XIX of the Social
25    Security Act. Notwithstanding any other provision of law,
26    the Department (i) does not have a claim against the

 

 

10200SB1041ham001- 18 -LRB102 04857 KTG 30261 a

1    estate of a deceased recipient of services under this
2    paragraph 16 and (ii) does not have a lien against any
3    homestead property or other legal or equitable real
4    property interest owned by a recipient of services under
5    this paragraph 16.
6        17. Persons who, pursuant to a waiver approved by the
7    Secretary of the U.S. Department of Health and Human
8    Services, are eligible for medical assistance under Title
9    XIX or XXI of the federal Social Security Act.
10    Notwithstanding any other provision of this Code and
11    consistent with the terms of the approved waiver, the
12    Illinois Department, may by rule:
13            (a) Limit the geographic areas in which the waiver
14        program operates.
15            (b) Determine the scope, quantity, duration, and
16        quality, and the rate and method of reimbursement, of
17        the medical services to be provided, which may differ
18        from those for other classes of persons eligible for
19        assistance under this Article.
20            (c) Restrict the persons' freedom in choice of
21        providers.
22        18. Beginning January 1, 2014, persons aged 19 or
23    older, but younger than 65, who are not otherwise eligible
24    for medical assistance under this Section 5-2, who qualify
25    for medical assistance pursuant to 42 U.S.C.
26    1396a(a)(10)(A)(i)(VIII) and applicable federal

 

 

10200SB1041ham001- 19 -LRB102 04857 KTG 30261 a

1    regulations, and who have income at or below 133% of the
2    federal poverty level plus 5% for the applicable family
3    size as determined pursuant to 42 U.S.C. 1396a(e)(14) and
4    applicable federal regulations. Persons eligible for
5    medical assistance under this paragraph 18 shall receive
6    coverage for the Health Benefits Service Package as that
7    term is defined in subsection (m) of Section 5-1.1 of this
8    Code. If Illinois' federal medical assistance percentage
9    (FMAP) is reduced below 90% for persons eligible for
10    medical assistance under this paragraph 18, eligibility
11    under this paragraph 18 shall cease no later than the end
12    of the third month following the month in which the
13    reduction in FMAP takes effect.
14        19. Beginning January 1, 2014, as required under 42
15    U.S.C. 1396a(a)(10)(A)(i)(IX), persons older than age 18
16    and younger than age 26 who are not otherwise eligible for
17    medical assistance under paragraphs (1) through (17) of
18    this Section who (i) were in foster care under the
19    responsibility of the State on the date of attaining age
20    18 or on the date of attaining age 21 when a court has
21    continued wardship for good cause as provided in Section
22    2-31 of the Juvenile Court Act of 1987 and (ii) received
23    medical assistance under the Illinois Title XIX State Plan
24    or waiver of such plan while in foster care.
25        20. Beginning January 1, 2018, persons who are
26    foreign-born victims of human trafficking, torture, or

 

 

10200SB1041ham001- 20 -LRB102 04857 KTG 30261 a

1    other serious crimes as defined in Section 2-19 of this
2    Code and their derivative family members if such persons:
3    (i) reside in Illinois; (ii) are not eligible under any of
4    the preceding paragraphs; (iii) meet the income guidelines
5    of subparagraph (a) of paragraph 2; and (iv) meet the
6    nonfinancial eligibility requirements of Sections 16-2,
7    16-3, and 16-5 of this Code. The Department may extend
8    medical assistance for persons who are foreign-born
9    victims of human trafficking, torture, or other serious
10    crimes whose medical assistance would be terminated
11    pursuant to subsection (b) of Section 16-5 if the
12    Department determines that the person, during the year of
13    initial eligibility (1) experienced a health crisis, (2)
14    has been unable, after reasonable attempts, to obtain
15    necessary information from a third party, or (3) has other
16    extenuating circumstances that prevented the person from
17    completing his or her application for status. The
18    Department may adopt any rules necessary to implement the
19    provisions of this paragraph.
20        21. Persons who are not otherwise eligible for medical
21    assistance under this Section who may qualify for medical
22    assistance pursuant to 42 U.S.C.
23    1396a(a)(10)(A)(ii)(XXIII) and 42 U.S.C. 1396(ss) for the
24    duration of any federal or State declared emergency due to
25    COVID-19. Medical assistance to persons eligible for
26    medical assistance solely pursuant to this paragraph 21

 

 

10200SB1041ham001- 21 -LRB102 04857 KTG 30261 a

1    shall be limited to any in vitro diagnostic product (and
2    the administration of such product) described in 42 U.S.C.
3    1396d(a)(3)(B) on or after March 18, 2020, any visit
4    described in 42 U.S.C. 1396o(a)(2)(G), or any other
5    medical assistance that may be federally authorized for
6    this class of persons. The Department may also cover
7    treatment of COVID-19 for this class of persons, or any
8    similar category of uninsured individuals, to the extent
9    authorized under a federally approved 1115 Waiver or other
10    federal authority. Notwithstanding the provisions of
11    Section 1-11 of this Code, due to the nature of the
12    COVID-19 public health emergency, the Department may cover
13    and provide the medical assistance described in this
14    paragraph 21 to noncitizens who would otherwise meet the
15    eligibility requirements for the class of persons
16    described in this paragraph 21 for the duration of the
17    State emergency period.
18        22. All women of childbearing age, regardless of
19    income level.
20    In implementing the provisions of Public Act 96-20, the
21Department is authorized to adopt only those rules necessary,
22including emergency rules. Nothing in Public Act 96-20 permits
23the Department to adopt rules or issue a decision that expands
24eligibility for the FamilyCare Program to a person whose
25income exceeds 185% of the Federal Poverty Level as determined
26from time to time by the U.S. Department of Health and Human

 

 

10200SB1041ham001- 22 -LRB102 04857 KTG 30261 a

1Services, unless the Department is provided with express
2statutory authority.
3    The eligibility of any such person for medical assistance
4under this Article is not affected by the payment of any grant
5under the Senior Citizens and Persons with Disabilities
6Property Tax Relief Act or any distributions or items of
7income described under subparagraph (X) of paragraph (2) of
8subsection (a) of Section 203 of the Illinois Income Tax Act.
9    The Department shall by rule establish the amounts of
10assets to be disregarded in determining eligibility for
11medical assistance, which shall at a minimum equal the amounts
12to be disregarded under the Federal Supplemental Security
13Income Program. The amount of assets of a single person to be
14disregarded shall not be less than $2,000, and the amount of
15assets of a married couple to be disregarded shall not be less
16than $3,000.
17    To the extent permitted under federal law, any person
18found guilty of a second violation of Article VIIIA shall be
19ineligible for medical assistance under this Article, as
20provided in Section 8A-8.
21    The eligibility of any person for medical assistance under
22this Article shall not be affected by the receipt by the person
23of donations or benefits from fundraisers held for the person
24in cases of serious illness, as long as neither the person nor
25members of the person's family have actual control over the
26donations or benefits or the disbursement of the donations or

 

 

10200SB1041ham001- 23 -LRB102 04857 KTG 30261 a

1benefits.
2    Notwithstanding any other provision of this Code, if the
3United States Supreme Court holds Title II, Subtitle A,
4Section 2001(a) of Public Law 111-148 to be unconstitutional,
5or if a holding of Public Law 111-148 makes Medicaid
6eligibility allowed under Section 2001(a) inoperable, the
7State or a unit of local government shall be prohibited from
8enrolling individuals in the Medical Assistance Program as the
9result of federal approval of a State Medicaid waiver on or
10after June 14, 2012 (the effective date of Public Act 97-687)
11this amendatory Act of the 97th General Assembly, and any
12individuals enrolled in the Medical Assistance Program
13pursuant to eligibility permitted as a result of such a State
14Medicaid waiver shall become immediately ineligible.
15    Notwithstanding any other provision of this Code, if an
16Act of Congress that becomes a Public Law eliminates Section
172001(a) of Public Law 111-148, the State or a unit of local
18government shall be prohibited from enrolling individuals in
19the Medical Assistance Program as the result of federal
20approval of a State Medicaid waiver on or after June 14, 2012
21(the effective date of Public Act 97-687) this amendatory Act
22of the 97th General Assembly, and any individuals enrolled in
23the Medical Assistance Program pursuant to eligibility
24permitted as a result of such a State Medicaid waiver shall
25become immediately ineligible.
26    Effective October 1, 2013, the determination of

 

 

10200SB1041ham001- 24 -LRB102 04857 KTG 30261 a

1eligibility of persons who qualify under paragraphs 5, 6, 8,
215, 17, and 18 of this Section shall comply with the
3requirements of 42 U.S.C. 1396a(e)(14) and applicable federal
4regulations.
5    The Department of Healthcare and Family Services, the
6Department of Human Services, and the Illinois health
7insurance marketplace shall work cooperatively to assist
8persons who would otherwise lose health benefits as a result
9of changes made under Public Act 98-104 this amendatory Act of
10the 98th General Assembly to transition to other health
11insurance coverage.
12(Source: P.A. 101-10, eff. 6-5-19; 101-649, eff. 7-7-20;
13revised 8-24-20.)
 
14    Section 99. Effective date. This Act takes effect January
151, 2022.".