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Dear Avisery Members,
On June 16, 2023, the Department of Healthcare and Family Services (HFS) filed emergency notice to pause enrollment into the Health Benefits for Immigrant Adults as of July 1, 2023.
The emergency rule and notice include additional changes that affect individuals in the Health Benefits for Immigrant Adults and Health Benefits for Immigrant Seniors program including adding copays to services, limiting backdated coverage, and potentially pausing enrollment into the Health Benefits for Immigrant Seniors program. See below for further information and for suggested advocacy actions.
BACKGROUND
Health Benefits for Immigrant Seniors (HBIS) and Health Benefits for Immigrants Adults (HBIA) are state-funded programs that provide health care coverage for those who do not qualify for federally funded Medicaid in Illinois due to their immigration status. HBIS started in 2020 for individuals 65 and older. HBIA began in April 2022 for those 55-64 and expanded to those age 42 and older in July 2022. For more information on the programs click here for HBIS and here for HBIA.
On June 16, 2023, HFS filed emergency rules to pause enrollment into the HBIA program, implement copays for certain services, and limit backdated coverage. Click here to read the full notice. The authority to file emergency rules was recently granted by the Illinois General Assembly though SB1298. Click here to read Avisery’s alert about the enrollment pause into HBIA.
NEW COPAYS AND LIMITED BACKDATED COVERAGE
Starting July 1, 2023 providers can impose cost sharing amounts on certain services when Emergency Medicaid is not applicable. The cost sharing amounts are as follows:
- Inpatient Hospital stay: $250 copay
- Hospital Emergency Room visit: $100 copay
- Hospital or Ambulatory Surgical Treatment Center outpatient services: 10% of the Department rate.
Currently, an individual enrolled in HBIA or HBIS can receive backdated coverage for up to 3 months prior to their effective date. With the emergency rule, HFS now has the option of limiting or eliminating backdated coverage for individuals.
ENROLLMENT INTO HBIS
New enrollments into the HBIS program will continue to be accepted after July 1st. However, in a press statement released on June 16th, HFS stated they will pause enrollment into HBIS once there are 16,500 individuals enrolled. (As of June 7, 2023, HBIS has 14,584 enrollees). Click here to read the press statement.
ACTIONS TO TAKE
Professionals and advocates who wish to register concerns about the impact of the emergency notice and rules on immigrant older adults and immigrants with disabilities can submit comments to both HFS and to the Joint Committee on Administrative Rules (JCAR). JCAR is a bipartisan legislative oversight committee with the authority to review any administrative rules promulgated by state agencies. Avisery encourages acting as soon as possible given the proposed effective date of July 1 and recommends using all three methods for comment submission:
- Submit a comment to JCAR by emailing jcar@ilga.gov
- Submit a comment to HFS by emailing HFS.Rules@illinois.gov
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Post your comment directly to the HFS notice by filling out this form and pasting your comment in the comment box: https://hfs.illinois.gov/info/legal/publicnotices/shareyourcomments.html
Please reach out to Avisery at avisery@ageoptions.org if you would like guidance on submitting comments and/or to share comments you have submitted. We are interested in gathering more information on how these changes will impact the communities you serve.
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