December 2018

When Governor-elect JB Pritzker and incoming legislators take office a few days from now, we hope among the top-of-mind issues for them will be healthcare – and the possibility of creating a public option that would allow Illinois residents to purchase a premium to participate in the state’s Medicaid program. Candidate JB Pritzker talked about his vision for such an initiative, which he called “ IllinoisCares ,” and his platform included a public health insurance option that would be available to all residents.

IllinoisCares would allow Illinois residents to purchase health insurance from the state, rather than a commercial plan. Forty-two states – including Illinois – already have Medicaid buy-in programs, but they are limited to working people with disabilities who have not been able to purchase affordable health insurance coverage that meets their health needs in the private market.The public option was a feature of early drafts of what became Obamacare, but it did not make it into the final law.

In 2018 there was a lot of debate about “Medicare for all,” another incarnation of the public option concept. Unlike Medicare, however, Medicaid is essentially a state program, and has more-comprehensive coverage than Medicare. As a result, a public option built off of a state’s Medicaid program is seen by some as a better option for people and payers. [...] Read more



Illinois’ integrated health homes were set to launch voluntary enrollment January 1, but the Department of Healthcare and Family Services announced in a November 30 provider notice that enrollment will be delayed until the program's implementation rules can be heard and approved by the HFS Joint Committee on Administrative Rules. Auto-assignment of patients is expected to start a couple of months after the launch.

Integrated health homes, a key part of the state's 1115 Behavioral Health Transformation, are aimed at increasing coordination of physical, behavioral, and social healthcare in Medicaid. Set up at community-based providers, they will coordinate the care of high-needs Medicaid beneficiaries. They will be incorporated into MCOs, and will eventually serve all members of the Illinois Medicaid population, with patients assigned to a tier based on their level of need.



The first evaluation report on Illinois’ Medicare-Medicaid Alignment Initiative (MMAI) was released by the Centers for Medicare and Medicaid. MMAI was created to test the financial and outcomes effectiveness of integrated care models for Medicare-Medicaid dual enrollees. The Illinois demonstration was launched in March 2014 with eight plans selected to take part – six in the Chicago area and two in central Illinois. More than 153,000 beneficiaries were eligible, and about 46,000 (30%) were enrolled. The report includes findings from qualitative data for the first three years of the demonstration and quantitative results for demonstration year 1.