End of Session Report
We went into the 2nd year of the 97th General Assembly predicting a political minefield of Education, Pension, Medicaid & Healthcare reform while legislators simultaneously struggled with maintaining tenuous public favor while running in entirely new legislative districts. Although no agreement was reached on pension reform, the Legislature adjourned on time (May 31st) choosing to avoid even tougher votes in an overtime session (when a supermajority would be required for passage).
At the time of this writing, the House is scheduled to come back in mid-August for the purpose of disciplining Representative Derrick Smith (arrested for bribery) and potentially revisiting pension reform.
Affordable Care Act
It does not appear as if the Supreme Court’s decision to uphold the Affordable Care Act should impact chiropractic physicians any differently than any other physicians in Illinois. Moreover, it maintains the non-discrimination language for providers. The ACA and the ICS believe that this language will help provide parity for chiropractic physicians in Illinois by mandating equality among provider types operating within their scope of practice.
It was determined that the insurance mandate is constitutional due to a classification as taxable criteria. It isn’t illegal to be without health insurance, but those who elect to go without coverage must pay an additional tax.
State Based Health Exchanges
The Governor has indicated that he plans to proceed in two phases. Since Illinois did not act while the Affordable Care Act was being weighed by the Supreme Court, it is no longer (politically) possible for Illinois to get its own Exchange up and running in time, so they will fall back to a state/federal partnership for the first year. In the meantime, the Statehouse will resume talks about creating an exchange on its own terms to implement in the following year.
A plan to reduce Medicaid spending by $2.7 billion was introduced by the Governor. His initial proposal to revamp Medicaid in Illinois included the elimination of all optional services such as hospice care, dental, chiropractic care, prescriptions, eyeglasses, and many others. Despite strong opposition by the ICS, adult chiropractic care was eliminated for the time being from the Medicaid program. Many chiropractic allies at the Statehouse hope to have it reinserted after we give the state “some time to get its finances in order.”
Overall, Illinois hopes to achieve $1.6 billion in savings from cutting programs and implementation of utilization controls as well as collecting about $1.0 billion in revenue from increases to the cigarette tax ($1 per pack) and hospital provider fees matched with federal funds.
Doubling Licensure Fees
HB4071 (Flowers) and HB4634 (Rita) would have effectively doubled the cost of licensure in Illinois for chiropractic physicians. Last year there was an attempt to triple our fees, but like last year, this bill failed. We have argued that the reason for the shortage at IDFPR is due to funding sweeps into General Revenue, not because the charged rate was insufficient. This would mean that any increase would be a tax and not a fee.
HB 3812 would have required that, before doing a referral to another healthcare provider, the referring physician would be responsible for verifying that the new provider was also in-network with the patient’s insurance company. Due to the opposition, the bill was changed to put the onus on the insurance company instead of the doctor, but the bill died regardless.
Health Care Liens
HB5823 (Thapedi) would have prohibited physicians from collecting their full payment from a personal injury case. The bill would have reduced the amount of a lien or other claim that a party would have on the award if the injured party is found to have a comparative fault or for any other cause. In response to opposition from the Illinois Chiropractic Society and the Illinois State Medical Society, Senate amendment #1 removed the offensive language and our objections.