After a spring upended by the COVID-19 pandemic, state lawmakers returned to Springfield late last month for an abbreviated legislative session.
A key figure in the discussions and negotiations was House Majority Leader Greg Harris, D-Chicago.
He spoke at a Health News Illinois live virtual event Thursday morning about the session’s implications for healthcare, what issues lawmakers did not have enough time to address and future legislative responses to the pandemic.
Read more below.
HNI: What were some of the healthcare highlights from the legislative session?
GH: So we did put $830 million to healthcare in various forms to address COVID-19. So this would be additional rates for providers, hazard pay, money to support PPE, for hospitals, FQHCs, other healthcare providers, nursing homes, (developmental disability) facilities, long-term care. We’re also, like so much we’re doing now, addressing a lot of this through an equity lens because the entire COVID-19 issue has brought to the forefront the disparities in which communities are suffering unduly from this, layered on top of historic healthcare disparities. So it’s really a call to us to start making decisions to remedy a lot of those disparities. So we’ve started that in the COVID CARES funding. We put more money into FQHCs. Like so many other healthcare providers, they are the front line for so many communities, especially where folks are uninsured or underinsured. Like other folks, they are losing revenue as more regular clientele is not coming in. Same with hospitals and other providers, and that’s something we’re gonna have to look at going forward, is how do we address revenue loss by our healthcare facilities? We started to allow, I think we’re the first state in the country to begin to allow Medicaid-like benefits for undocumented people who are 65 years and older. We changed the law to allow FQHCs to take sexual assault victim kits and counseling because so many hospital emergency rooms have not been available for folks to access. And of course, we redid the hospital assessment, which brought in over 400 million new dollars to the healthcare system in Illinois. It allowed us to give the first physician rate increase in decades, I think. We prioritized our safety net and high Medicaid hospitals in this to be sure that those serving the most Medicaid patients are getting extra resources from the state. And we set aside $150 million for an eventual hospital transformation program. We’ll be working over the summer with stakeholders on how to design the criteria and the eligibility for that.
HNI: What are some of your healthcare priorities that did not advance this session?
GH: There was a lot that did not get done that we’ll still have to address. But given that we were there for an emergency to get the must-do items passed and to do everything we could to provide stability and predictability for our healthcare providers in the state of Illinois, I think that was a huge accomplishment. We did not decide to balance the budget on the backs of healthcare providers or citizens who were seeking care. We protected community behavioral health, protected substance abuse resources. We put more money into hospitals. Another thing we did, looking toward the future, is at the governor’s request, I introduced a bill that will initiate a study on how healthcare access and healthcare payment should be changed for the future in Illinois. It’ll institute a study of a different variety of tactics and strategies that we’ve seen nationally, that we’ve seen other states do, whether it be risk corridors, reinsurance strategies, Medicaid buy-in and public options, to begin to engage in re-envisioning what our healthcare delivery system should look like for a new world.
HNI: Is there anything else that sticks out to you that wasn’t addressed during the session?
GH: One of the things that a lot of people had hoped for was a statutory expansion of the telehealth rules that came into place through the executive orders during COVID. There were differences of opinions on how to get that done. So it did not happen, but the executive orders will be in place until the end of the year. So the telehealth system as it is should remain intact. So there won’t be any abrupt dislocations. But that’s one of the things we need to continue to look at. Other things we should be looking at are expanding community-based care. As we’ve seen now in COVID, there are a lot of times where it’s going to be hard, or people will not want to go into congregate settings or the hospital settings or clinic settings. So how do we deliver healthcare at home also?
HNI: There seemed to be a lot of legislative support for telehealth expansion. Why did this not make it through? Is this something lawmakers will reconsider?
GH: I think this is an issue if we had a regular session and if we had more time to work through all the issues in a traditional way with committee hearings and more active stakeholder and public involvement over a couple of months, this was an issue that probably could have been worked out. But trying to force that into a couple of days just became too big of a lift on that issue. So I think all the different sides have committed to work through the summer and come up with an appropriate response.
HNI: The COVID-19 pandemic has further exposed long-lasting healthcare disparities in African American and other minority communities. Going forward, what more can lawmakers do to address these healthcare disparities?
GH: I think this is one of the things now that will be looked at in this study. I think there are some short-term things we can do that involve shifting some resources around. But also, I think our healthcare system in a lot of ways just systematically has changed. You’ve seen this huge shift from hospitalization and inpatient care to outpatient care. But a lot of our physical structures were built based on large, central hospitals. But now care seems to be delivered more in communities. And how do we address that? Increasing reliance on pharmaceuticals rather than medical or surgical interventions for different things, how do you address that? The growing impact of behavioral health challenges for all of us, given the stress and the fear and all these incidents unfolding around us, how are we sure that communities have equitable access to healthcare and that there are providers there and that there are people going to be prescribing there? And now what role does telehealth play? And that’s not just for city communities, but suburban communities, central Illinois, downstate communities, all are facing different versions of the same challenge.
HNI: Do you anticipate that the Legislature will need to come back before the fall veto session to address COVID-19?
GH: Well, I think if we come back in the summer, we need to have a good list and set of priorities. Things that we can address and that we can finish. So I think it’s important to do a lot of groundwork, to study, to have a good set of recommendations so that, if we do come back, we can be successful and get stuff done. So a lot of groundwork would have to be laid. And then certainly for the veto session, I think we’ll have a much better picture – hopefully in the rearview mirror – on what COVID has done to Illinois, to our families, to our healthcare system, to our businesses and to workers. It’s hard to predict what that’s going to look like right now. So I think we’re just going to be really adept at reacting quickly and being as thoughtful and careful in planning responses as we can be.
HNI: The hospital assessment program includes $150 million for hospital transformation funding that cannot be allocated until the General Assembly decides on the details. How will that process work and how would this be different than past efforts to distribute transformation funding?
GH: We saw as we were planning to pass the hospital assessment, the entire world get upended by COVID. And a lot of assumptions about hospital utilization and just so many other things that we had all made as assumptions and thinking about what should our plans be, that all got turned on its head in the last couple months. All over the state, in every corner of the state. So, again, it was one of those things where in a period of three or four days, folks were thinking we need to be more thoughtful and we need to really learn the lessons that COVID has taught us about disparities before we obligate $150 million for transformation. We need to be very careful… to be sure that the money that is going to transformation is going to be what communities want it to be and will help reduce disparities. I think that, again, is something the Medicaid working group will do over the summer.
HNI: As the details get hashed out, what type of things do you anticipate or would you like to see this funding focused on?
GH: It’s not really up to me. It’s got to be up to all of the members of our working group. They’re really representative of all the different communities of the state: rural, suburban, city, African American community, Latinx community, Republicans and Democrats. We’ve had a good track record of both caucuses in both chambers and the governor’s office and state agencies working well with stakeholders to come up with a solution. So it’s not what I think. It needs to be the collective wisdom of a lot of people trying to figure out how to go forward given the new realities we’re living in right now.
HNI: A group of four south side Chicago hospitals called off their merger after the session because they did not receive the hospital transformation funding they were hoping for. Why was that specific request not included in the final plan?
GH: We did not put a transformation program on the books at all. This would have been something that would have had to apply through that program. And also, I think that the local legislators representing that area have concerns about that proposal, which they were fairly public about. I would say that there’s still an opportunity, but it needs to be things that can be supported by the local communities.
HN: Included in the budget was nearly $20 million for nine hospitals for Medicaid managed care. How were those nine hospitals chosen and how do you respond to criticisms that you’re leaving out other hospitals that could have used those funds?
GH: These were priorities, particularly for the Black Caucus looking at communities where their hospitals were just getting slammed with COVID patients and where the healthcare disparities and generations of disinvestment and racism are reaping their toll now. They believed that our supporting those hospitals to keep them open and keep them functioning, particularly now in this crisis, was what we needed to do. And hopefully, that kind of support will keep them going.
HNI: It’s been a grueling past couple of months, but what are you most optimistic about right now?
GH: I think that so many of these things are now pushing us to make some real big choices of how we go forward. So it’s gonna be an exciting time. It probably won’t be easy to shift systems that have existed one way for many, many years. It’s always a big push to make the ship move in a different direction, but I think we’re seeing that now’s the time we should be making some of those pushes.
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