HR0445enr 100TH GENERAL ASSEMBLY

HR0445 Enrolled LRB100 12760 MST 26779 r

HOUSE RESOLUTION 445

On May 5, 2017, the United States House of Representatives passed H.R. 1628, otherwise known as the American Health Care Act (AHCA); and

WHEREAS, In March of 2017, the Congressional Budget Office estimated that 24 million people would lose health insurance if the AHCA were passed and implemented; of those 24 million people, 14 million are currently covered by Medicaid, which the AHCA would also slash by about $880 billion over 10 years, putting some of the poorest and most vulnerable citizens at great risk; and

WHEREAS, As a result of passage of the AHCA, Illinois could face a loss of $40 billion in federal Medicaid funding over the next 10 years, affecting over one million Illinois residents who currently have coverage under the Affordable Care Act; and

WHEREAS, Currently, Illinois is ranked 50th in the nation for capturing federal Medicaid dollars putting the State in an extremely vulnerable position and unable to absorb more costs from the federal government; and

WHEREAS, The AHCA also allows states to waive community rating, which bans insurers from charging higher premiums to those with pre-existing conditions and would result in much higher premiums for people with pre-existing conditions; and

WHEREAS, As a result of waiving the ban on pre-existing conditions, the cost of insurance will increase for people with pre-existing conditions such as cancer, diabetes, arthritis, autistic disorder, seizures, asthma, kidney disease, and children with disabilities; and

WHEREAS, The AHCA also has a provision letting states waive essential health benefits such as outpatient care, emergency services, hospitalization, pregnancy, maternity, newborn care, mental health and substance use disorder services, and pediatric services; and

WHEREAS, Waiving of essential benefits puts mothers and children at severe risk of losing coverage as plans on the individual market can once again decide not to cover maternity care as a result of the AHCA; and

WHEREAS, The law would also adopt a policy known as a "per capita cap" for Medicaid that would replace the current funding mechanism and rather than matching state spending; the AHCA would give each state a set amount of money per person and place specific caps for differing populations such as the people with disabilities, the elderly, and other at-risk populations; and

WHEREAS, As a result of placing a cap on spending, people with disabilities who rely on home and community based services through Medicaid, such as personal-attendant care, skilled nursing, and specialized therapies could lose access to the services they need in order to live independently and remain in their homes; and

WHEREAS, The AHCA also places the elderly at risk; as states continue to see rising populations as a result of the baby boom generation, implementing a per capita cap on spending may restrict states' abilities to keep up with the demand for services resulting in premature institutionalization, lack of services, and reduced quality of life for our seniors; and

WHEREAS, The AHCA poses a threat for persons with substance abuse disorders; the opioid crisis in Illinois has placed a heavier burden on the State's Medicaid program and has resulted in an immense need for increased services; a per capita cap will limit the State's ability to leverage additional monies in times of crises or epidemic, further hampering the State's ability to be responsive to the needs of its most vulnerable populations during the most critical times; and

WHEREAS, The law allows states to impose work requirements on those applying for Medicaid, which has not been proven to increase employment among the poor and will meaningfully reduce access to care for low income families; and

WHEREAS, On June 22, 2017, the United States Senate introduced a proposed amendment for discussion to H.R. 1628, known as the Better Care Reconciliation Act of 2017; and

WHEREAS, While the Better Care Reconciliation Act of 2017 contains changes to the original AHCA, the new proposed amendment still contains significant cuts to both state Medicaid programs as well as state healthcare exchanges and continues to put some of the poorest and most vulnerable citizens at great risk; and

WHEREAS, The legislation results in over 22 million people losing their insurance coverage, and reduces spending on healthcare services by over $700 billion while also providing over $541 billion in tax breaks for extremely wealthy individuals and corporations; and

WHEREAS, The Better Care Reconciliation Act of 2017 continues to propose elimination of health insurance coverage for the Medicaid expansion population in Illinois, thus completely eliminating healthcare coverage for over 650,000 Illinoisans who currently only have insurance as a result of the State's decision to expand Medicaid; and

WHEREAS, The act also continues to pursue "per capita caps" for Medicaid severely placing billions of dollars in federal funding in jeopardy for Illinois which may result in elimination of services, reductions in services offered, rate cuts for providers, or limiting coverage of high cost enrollees; and

WHEREAS, The Better Care Reconciliation Act of 2017 reduces the amount of subsidies to persons who purchase health insurance on the healthcare exchange, and reduces the amount of persons eligible to receive the subsidies for exchange plans that provide less health insurance plans and contain higher deductibles than current healthcare plans on the exchange; and

WHEREAS, The act continues its attack on healthcare for women by reducing access to family planning services and maternity care services, and allowing insurance companies to charge higher premiums for women; and

WHEREAS, The Better Care Reconciliation Act of 2017 also places seniors at an even higher risk of losing nursing home care than the AHCA as a result of eliminations of presumptive eligibility for Medicaid recipients to obtain benefits and retroactive eligibility for Medicaid recipients to get paid for services they have already received; and

WHEREAS, The Better Care Reconciliation Act of 2017 also continues to allow states to waive essential health benefits as provided under the Affordable Care Act, continually placing many people at risk of losing the most basic healthcare benefits such as maternity care, mental health care, substance abuse and opioid treatment, and pharmacy benefits; and

WHEREAS, The true intention of both policies are revealed in the provisions that create financial incentives for states to increase Medicaid redeterminations in order to kick people off of the Medicaid program, and financial incentives for states to reduce the amount of healthcare services provided by Medicaid; and

WHEREAS, The Governor has yet to officially take a position on the American Health Care Act or the Better Care Reconciliation Act of 2017, despite the fact that both stand to negatively affect millions of Illinois residents and cause major financial harm to the State's budget and the broader system of healthcare across Illinois; and

WHEREAS, When the Governor has been asked to provide a position on the American Health Care Act or the Better Care Reconciliation Act of 2017, he has continually dodged the question, refused to provide a direct answer, or attempted to circumvent any responsibility for these proposed policies; and

WHEREAS, As the Governor has the supreme executive power in the State under the Illinois Constitution, it is imperative that he directly provide guidance to our Congressional delegation and the people of Illinois regarding his position on the American Healthcare Act and the Better Care Reconciliation Act of 2017, both of which will have a disastrous effect on the poorest and neediest persons in the State and will devastate the critical social safety net they rely on; and

WHEREAS, Medicare is a federal health insurance program that currently pays for a variety of health care expenses for senior citizens aged 65 and older and people with certain other qualifying conditions only; and

WHEREAS, Medicare currently insures over 55 million Americans, and nearly everyone over age 65; in Illinois alone, over 2 million people receive Medicare benefits; and

WHEREAS, There have been recent legislative efforts at the federal level to expand Medicare for all persons in the United States, not just those currently eligible which would provide coverage for all medically necessary services, including doctors' visits, hospital care, prevention programs, long-term care, mental health, reproductive health care, dental, vision, prescription drug, and medical supply costs; and

WHEREAS, Children (unmarried and under age 22) can only receive Medicare if they are disabled or have a qualifying condition and make up less than 7% of the current population of people on Medicare; and

WHEREAS, Expanding the federal Medicare program to those who need care the most can be a positive step to strengthen our nation's commitment to improving the health and safety of all Americans and reduce the risk of cuts posed by the AHCA and the Better Care Reconciliation Act of 2017, to those that are most vulnerable; therefore be it

RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE ONE HUNDREDTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we strongly urge the federal government, the United States Congress, and the President of the United States, to oppose the American Health Care Act, the Better Care Reconciliation Act of 2017, or any other legislative efforts that would reduce access to healthcare for low-income and at-risk populations and to expand the federal Medicare program for people most in need especially children, women, and those with pre-existing conditions, that are put at extreme risk as a result of passage of either the American Health Care Act or the Better Care Reconciliation Act of 2017; and be it further

RESOLVED, That we strongly urge the Governor of the state of Illinois to be responsive to the needs of Illinois residents and directly engage with the President of the United States, and Republican members of the Illinois Congressional delegation regarding the devastating consequences associated with both the American Health Care Act and the Better Care Reconciliation Act of 2017; and be it further

RESOLVED, That suitable copies of this resolution be delivered to the Governor of the State of Illinois, the Illinois Congressional delegation, the United States Congress, and the President of the United States.