January 08, 2015
By Ally Marotti

A state task force wants Illinois to create a health insurance exchange for undocumented residents and expand the Medicaid program to cover legal immigrants who aren't eligible to receive federally funded benefits.

Those were among dozens of recommendations in a report released yesterday by the Alliance for Health, a group of more than 500 health experts and community advocates organized last year by Gov. Pat Quinn's Office of Health Innovation and Transformation.

Health care in Illinois is in a state of flux as providers adjust to changes spurred by the Affordable Care Act. The report recommends ways for the health system to transform smartly and efficiently in Illinois as well as ways to implement funding for Medicaid reform.

CHANGES FOR THE UNDOCUMENTED

The state-run marketplace would provide individuals and small businesses with a place to compare private health insurance options. Undocumented immigrants are not eligible to participate in the federal marketplace, but the state exchange would be open to them since federal money would not be used, said Michael Gelder, Quinn's senior health policy adviser.

The report did not detail plans for establishing the state-run marketplace.

The report also recommends expanding state-funded Medicaid to cover people who immigrated to the U.S. legally and hold a visa or have obtained a work permit but have not yet become eligible or are excluded from federally funded public benefits.

Private health insurance companies also should be discouraged from requiring a Social Security number to purchase coverage, according to the report.

“The goal here is not to have any group of people relegated to emergency rooms for their care,” Gelder said. “This is a group that might still utilize emergency rooms if they don't have insurance, so we want to avoid the high costs of ER care and the conditions that become so bad you have to go to the ER.”

'HUGE CHUNK OF PEOPLE'

Stephani Becker, a senior policy specialist at the Sargent Shriver National Center on Poverty Law, said those efforts would go a long way in health care reform.

“Any sort of state-only effort that would help cover those individuals would be huge,” she said. “It's over 100,000 (undocumented) people (in Illinois) going to ERs and having chronic conditions that aren't being seen. . . .It's a drain on the public health sector and eventually on the taxpayers, too.”

About 310,000 undocumented immigrants in Illinois are uninsured, according to a November report from Chicago-based consulting firm Rob Paral & Associates. That represents almost 59 percent of the state's undocumented immigrants.

Some undocumented immigrants can receive state-funded medical care, including pregnant women, who are eligible for prenatal care, and those under the age of 19, who are eligible for All Kids medical care in Illinois. Others obtain coverage through spouses or private providers.

“One of the main reasons the (Affordable Care Act) was passed was to even out the playing field, and we're missing a huge chunk of people,” Becker said.

CHALLENGES AHEAD

Gelder acknowledged that the three-part report, the first of which spans about 80 pages, is lofty. Some recommendations would take only months to implement, while others, such as changes in children's mental health services, are more long-term goals.

The suggestions made in the report incorporated the allocation of some pending and recently-received grants, Gelder said, including those that could be used for Medicaid reform.

Discussions surrounding Medicaid reforms were put on hold after the November elections. Gelder said they are waiting on input from the new administration. Republican Bruce Rauner will be sworn in as governor Jan. 12.

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