June 29, 2022

IL Medicaid is expanding: what does that mean for CommunityHealth?

CommunityHealth’s mission is to serve people without essential health care, and our vision is quality health care for all. Since 1993, we have worked toward that mission by providing extremely high quality primary and specialty care.

Our unique model of care, built upon the three pillars of volunteerism, partnerships, and philanthropy, has always been a disruption to the established health care system.  Not only are we providing consistent and trustworthy care to our patients, we are saving area hospitals about $9 million annually by keeping our patients healthy and out of the emergency department where urgent care of unmanaged conditions would be uncompensated.

The specialty services we provide are extremely difficult to find for both people who are uninsured and those who have Medicaid. Sometimes the services cannot be accessed at all, or at the Medicaid providers who do offer them, waits are extremely long (up to 10 months, based upon reports we have received from peer health centers and former patients who have become Medicaid-eligible).

CommunityHealth’s average appointment time of 45 minutes is also a rarity within the health care field, as providers who bill for services must often cut visit time down to only 15 or 20 minutes.

A step in the right direction

Over the past three years, the state of Illinois has been progressively expanding access to a health insurance plan that mirrors Medicaid to undocumented immigrants. This expansion is a huge win for immigrant rights in the state!

In July of 2022, Health Access for Immigrant Adults (HBIA) will be offered to Illinois residents as young as 42 years old. As many as half of all CommunityHealth patients seen last year could be eligible for this plan.. In light of this, CommunityHealth looked to our mission and our history to determine our next steps.

 

Staying patient-centered

While the number of people with insurance is increasing, the challenges of accessing care – particularly for poor (largely BIPOC) Chicago residents – are not going away. In its current form, the health care safety net is not prepared for this influx of newly insured patients.

Over the last two years, we have helped transitioning patients through the Medicaid enrollment process and stayed in touch with many of them. Some of the challenges they’ve faced have informed our strategy regarding the upcoming expansion:

  • Many former patients report difficulty finding practices in their area that accept their coverage.
  • Some have also experienced complications with receiving medication: though it should be covered under this plan, many pharmacies are not yet aware of this, and are asking for copays that patients cannot afford.
  • In seeking primary care, our former patients have faced confusion and delay. Health centers report an average wait time of 3-9 months for a new patient appointment (compared to less than 2 weeks at CommunityHealth).
  • Some specialty care is completely unavailable at this time, even with a referral. Many patients have expressed hesitancy about completing an Immigration Status Disclosure to the government – required to access this care.

The ever-changing health care landscape

The challenge posed by this expansion is made more complex by the fact that so much is still unknown.

  • The Illinois Department of Healthcare and Family Services has the abilty to impose limitations on the program (e.g., a capped number of enrollments).
  • Health Benefits for Immigrant Seniors/Health Benefits for Immigrant Adults is currently a budget line item in Illinois, but it has not been written into law. Therefore, it does not have any federal funding match, nor does it have any consumer protections. The danger of this is that it could easily be taken away, changed, or reduced in a variety of ways as a result of future political or financial shifts in Illinois.

 

Our mission, vision, and values remain unchanged

In light of the inadequacy of our current health care system and the potential impermanence of the expansion, it is clear CommunityHealth’s role as a safety net is as important as ever. Our vision is quality health care for all, and our mission is to serve people without essential health care.

Our Board of Directors and Medicaid Expansion Taskforce are carefully considering our options and planning for how to structure our business model in a way that best achieves that mission.

From now through December 31, 2022, we will continue to provide care to patients who meet our income eligibility guidelines – whether or not have they enrolled in this new insurance plan. It is our intention that by the end of the year, we will have a clearer sense of the environment and plan implementation, and we will know the best way to go forward.

No one should go without health care, and CommunityHealth remains dedicated to increasing access to quality health care for low-income populations in Chicago.