July 8, 2020
Governor J.B. Pritzker on Tuesday signed Senate Bill 1864 / PA101-649
, the Health Care Affordability Act, to help expand healthcare access in response to the COVID-19 pandemic. The legislation eliminates or loosens requirements on who can access Medicaid through the following actions:
- Provides the Dept. of Healthcare and Family Services (HFS) with the authority to accept an applicant’s or recipient’s attestation of income, incurred medical expenses, residency, and insured status when electronic verification is not available;
- Eliminates resource tests for some eligibility determinations;
- Suspends redeterminations;
- Suspends changes that would adversely affect an applicant’s or recipient’s eligibility;
- Allows phone or verbal approval by an applicant to submit an application in lieu of applicant signature;
- Allows adult presumptive eligibility for children, pregnant women, and adults as often as twice per calendar year; and
- Suspends premium and co-payment requirements.
The legislation also includes a key provision strongly advocated for by IHA that permits HFS to continue to pay for telehealth services, such as those outlined in the Governor’s COVID-19 emergency orders, for up to 12 months after the emergency period ends (the Governor’s current emergency declaration continues until late July). The new law also supports clinical trials by requiring Medicaid to cover routine care costs for members who participate in medical trials.
In addition, the law requires HFS, in consultation with the Dept. of Insurance, to explore options to make health insurance more affordable for low-income and middle-income residents. This study is to be submitted to the General Assembly by Feb. 15, 2021.