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90_SB0189
New Act
Creates the Health Security Act. Requires the State to
implement a universal access health care system by January 1,
2000. Requires creation of a Bipartisan Health Care Reform
Commission by September 1, 1997, to make recommendations for
a universal access health care plan. Effective immediately.
LRB9001614DJcd
LRB9001614DJcd
1 AN ACT concerning public health.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the
5 Health Security Act.
6 Section 5. Legislative findings. The General Assembly
7 recognizes that an estimated 1,500,000 Illinoisans are
8 without health insurance and that health care costs are
9 increasing at unacceptable rates. While we anticipate health
10 care reform at the national level, the General Assembly
11 believes this State must work to ensure access to the health
12 care system for all citizens of Illinois. At the same time,
13 this State must do a better job of containing health care
14 costs while maintaining the quality of health care. The
15 General Assembly finds that community-based, primary health
16 care services provided by a wide range of qualified health
17 care providers is the most effective means of achieving
18 individual and social health.
19 Section 10. Policy.
20 (a) It is the policy of the State of Illinois to ensure
21 that all residents have access to quality health services at
22 costs that are affordable. Comprehensive health planning
23 through the application of a statewide health resource
24 management plan linked to a unified health care budget for
25 Illinois is essential.
26 (b) On or before January 1, 2000, the State of Illinois
27 shall implement a health care system that does the following:
28 (1) Provides universal access to a full range of
29 preventive, acute, and long-term health care services.
30 (2) Maintains and improves the quality of health
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1 care services offered to Illinois residents.
2 (3) Provides portability of coverage regardless of
3 job status.
4 (4) Provides uniform benefits for all Illinois
5 residents.
6 (5) Encourages regional and local consumer
7 participation in decisions about health care delivery,
8 financing, and provider supply.
9 (6) Controls capital and overall expenditures.
10 (7) Avoids unnecessary duplication in the
11 development and offering of health care facilities and
12 services.
13 (8) Provides a mechanism for implementation of the
14 results of research to evaluate the effectiveness of
15 interventions, providers, and facilities.
16 Section 15. Bipartisan Health Care Reform Commission.
17 Not later than September 1, 1997, there shall be created the
18 Bipartisan Health Care Reform Commission ("the Commission").
19 The Commission shall consist of 26 members. The Directors of
20 Aging, Children and Family Services, Public Health, Public
21 Aid, and Insurance and the Secretary of Human Services (as
22 head of the successor agency to the Departments of Mental
23 Health and Developmental Disabilities and Rehabilitation
24 Services) shall be ex officio non-voting members of the
25 Commission. The remaining members shall be appointed as
26 follows: 5 by the President of the Senate, 5 by the Minority
27 Leader of the Senate, 5 by the Speaker of the House of
28 Representatives, and 5 by the Minority Leader of the House of
29 Representatives. The Commission shall include health care
30 consumers, health care providers, health policy analysts,
31 representatives of business, and economists. Members shall
32 be selected to provide a majority representation (no less
33 than 60%) of health care consumers. This representation may
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1 come from representatives of consumer and community groups.
2 Health care provider representation shall be proportional to
3 the number of those providers involved in the delivery of
4 health care (such as administrators, nurses, physicians, and
5 social workers). Selection of members of the Commission
6 shall be made to ensure proportional representation with
7 respect to geography, culture, gender, and age. The
8 Chairperson shall be elected at the first meeting of the
9 Commission by the members of the Commission. The Governor
10 also shall designate one or more departments of State
11 government to provide staff support and assistance to the
12 Commission.
13 Section 20. Recommendations for universal access plan.
14 (a) On or before January 1, 2000, the Commission shall
15 submit a report to the General Assembly which shall contain
16 (i) the Commission's recommendations for a universal access
17 plan based on the concept of regulated multiple payers and
18 (ii) the Commission's recommendations for a universal access
19 plan based on the concept of a single payer. The Commission
20 shall not be limited to the funding concepts described in the
21 preceding sentence. The Commission may also consider other
22 alternative funding mechanisms and make recommendations it
23 deems appropriate. The plans shall contain recommendations
24 that if implemented will provide universal access to a full
25 range of preventive, acute, and long-term health care
26 services by January 1, 2000. The Commission shall submit a
27 preliminary status report to the General Assembly by April 1,
28 1998, describing the progress of the Commission in
29 accomplishing its goals.
30 (b) For purposes of this Section:
31 (1) A single payer system is a method of financing
32 health services predominantly through public funds so
33 that every resident of Illinois receives a uniform set of
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1 benefits as established by law or rule. Policies
2 governing all aspects of the management of the single
3 payer system reside with State government, and benefits
4 are administered by a single entity.
5 The system includes the following features:
6 (A) Universal coverage for all Illinois
7 residents.
8 (B) A single governmental or nongovernmental
9 administrative entity which makes payments.
10 (C) Portability of coverage regardless of job
11 status.
12 (D) Uniform benefits from a single source for
13 all Illinois residents. (Private insurance is
14 confined to services excluded from uniform
15 benefits.)
16 (E) A broad-based public financing mechanism
17 with revenues from employer, employee, or public
18 sources, or a combination of those sources.
19 (F) A cap for provider expenditures, and
20 global budgeting for health care facilities.
21 (G) Capital expenditures controlled.
22 (H) A binding cap on overall expenditures.
23 (I) Policy-making for the system as a whole
24 and accountability reside with State government.
25 (2) A regulated multiple payer system is a method
26 of financing health services through a mix of public and
27 private funds so that every resident of Illinois receives
28 a uniform set of benefits as established by law or rule.
29 State government is responsible for regulating the
30 multiple entities that provide benefits to residents,
31 including regulations for enrollment, change in premium
32 rates, payment rates to providers, and aggregate health
33 expenditures. The system includes but is not limited to
34 the following features:
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1 (A) Health insurance may be through
2 employment, regionally or other-based; enrollment is
3 compulsory and universal.
4 (B) Claims are processed by multiple insurers.
5 (C) Portability of uniform benefits regardless
6 of job status.
7 (D) A uniform benefit plan for all Illinois
8 residents available from a variety of public or
9 private payers. (Services excluded from the uniform
10 benefit plan may be purchased through multiple
11 insurers or health purchasing cooperatives).
12 (E) The system is financed by employer,
13 employee, or public sources or a combination of
14 those sources; revenues are collected and dispersed
15 by insurers or health purchasing cooperatives.
16 (F) Uniform reimbursement for health care
17 facilities and providers regardless of payer or
18 reimbursement mechanism such as capitation, either
19 negotiated or regulated.
20 (G) Capital expenditures controlled.
21 (H) Binding cap on overall expenditures.
22 (I) State government is responsible for
23 regulating multiple insurers regarding enrollment,
24 premium costs, provider payments, and total
25 expenditures. Accountability for operating within
26 these parameters resides with insurers.
27 (c) Both plans shall provide for the use of the health
28 resource management plan and a unified health care budget.
29 Other health care cost containment mechanisms shall include
30 recommendations concerning the following:
31 (1) An integrated system or systems of health care
32 delivery.
33 (2) Incentives to be used to contain costs and
34 direct resources.
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1 (3) Uniform benefits that would be provided under
2 each plan.
3 (4) Reimbursement mechanisms for health care
4 providers.
5 (5) Administrative efficiencies.
6 (6) Mechanisms for generating spending priorities
7 based on multidisciplinary standards of care established
8 by verifiable replicated research studies demonstrating
9 quality and cost effectiveness of interventions,
10 providers, and facilities.
11 (7) Mechanisms for applying and implementing the
12 unified health care budget on a statewide basis to all
13 sectors of the health care system.
14 (8) Mechanisms for reducing the cost of
15 prescription drugs both as part of, and separate from,
16 the uniform benefit plan.
17 (9) Appropriate reallocation of existing health
18 care resources.
19 (10) Equitable financing of each proposal.
20 (d) In its report, the Commission shall present, at a
21 minimum, the range of services that would be available under
22 each plan if there were no increase, beyond inflation, in the
23 total gross health care expenditures in Illinois as
24 determined by the Commission for the first year that the
25 health care plan would be in effect.
26 (e) In developing the plans, the Commission shall
27 incorporate anticipated or actual health care reform measures
28 adopted at the federal level. The Commission shall review
29 those changes to assess their adequacy of meeting and
30 achieving the goals of this Act.
31 Section 25. Hearings on universal access plans. The
32 Commission shall seek public comment on the development of
33 the universal access plans. In seeking public comment on the
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1 development of the Commission's recommendations for universal
2 access plans, the Commission shall hold at least 8 public
3 hearings in different geographical regions of the State. The
4 hearings shall take place before the Commission's report is
5 submitted to the General Assembly. The Commission shall
6 consult with health care providers and health care consumers
7 in developing the Commission's recommendations for universal
8 access plans.
9 Section 30. Public education on universal access plans.
10 After submitting its report to the General Assembly, the
11 Commission shall develop and conduct extensive public
12 education in different geographic regions of the State on the
13 intent, content, and impact of each of the universal access
14 plans that have been recommended to the General Assembly.
15 All efforts shall be made to communicate fully with the
16 Illinois public to enable all sectors to be informed of the
17 Commission's recommendations for a universal access plan
18 based on the concept of regulated multiple payers and the
19 Commission's recommendations for a universal access plan
20 based on the concept of a single payer.
21 Section 35. Long-term care report.
22 (a) The Commission's report to the General Assembly
23 shall include recommendations for including long-term care
24 services in the universal access plans. Long-term care
25 services include those long-term care services presently
26 covered in Illinois under Title XIX of the Social Security
27 Act.
28 (b) Nothing in this Section shall preclude the
29 Commission from recommending cost sharing arrangements for
30 long-term care services, nor from recommending that those
31 services be phased in over time. The Commission's
32 recommendations shall support, and not serve to supplant,
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1 informal care giving by family and friends and shall include
2 cost-containment recommendations for any long-term care
3 service suggested for inclusion in the universal access
4 plans.
5 (c) The Commission's report shall estimate costs
6 associated with each of the long-term care services
7 recommended for inclusion in the universal access plans and
8 may suggest independent financing mechanisms for those
9 services. The report shall also set forth the projected cost
10 to the State and its citizens over the next 20 years if there
11 were no change in the present accessibility, affordability,
12 or financing of long-term care services in this State.
13 Section 99. Effective date. This Act takes effect upon
14 becoming law.