Issues: Health Care (LWVUS)
LWVUS Position in Brief
The League of Women Voters of the United States believes that a basic level of quality health care at an affordable cost should be available to all U.S. residents. Other U.S. health care policy goals should include the equitable distribution of services, efficient and economical delivery of care, advancement of medical research and technology, and a reasonable total national expenditure level for health care.
The complete position is available on page 32 of our Impact on Issues document.
League Activity 2017
LWVIL joined Protect Our Care Illinois (PoCIL), a Coalition of advocacy and social service groups to lobby for “no repeal of ACA without adequate replacement.” Letters were sent to Leagues in Congressional Districts with representatives supporting repeal. Members were asked to engage with them during the February recess through personal meetings, rallies and social media. Leagues organized Q and A Public Forums in April in the 14th District (Hultgren) and 16th (Kinzinger), two of seven IL representatives who supported straight repeal of the ACA. Rep. Roskam (6th District) refused to participate in a public meeting organized by Leagues in his District.
TFA: targeted U.S. Representatives to commit to a bill that is an acceptable and genuine replacement for ACA.
Also called Governor Rauner asking him to reinforce the IL Congressional Delegation due to the dire effects that a repeal without adequate replacement would have on Illinois financial status.
TFA: Contacted Governor Rauner to send a strong message to members of U.S. Congress, particularly the Illinois delegation, to refrain from voting for cuts to Medicaid benefits.
Also, Margaret O'Hara, LWVIL Health Care Issue Specialist, testified on a panel of nurses in support of HR 445 opposing the American Health Care Act. She cited experience with the financial devastation and lack of appropriate care that patients suffered with preexisting conditions and inadequate insurance. The panel proceeded to call out Governor Rauner on cuts to Medicaid.
TFA: Contacted Governor Rauner to publicly oppose cuts to Medicaid in any legislation to repeal, replace, or modify the ACA.
TFA: Contacted Governor Rauner and urged him to oppose the Graham-Cassidy proposal.
Additionally, prior to funding expiring on September 30, 2017, LWVIL joined a group of over 50 organizations -- all committed to improving health coverage for Illinois families -- in signing a letter urging members the the Illinois Congressional Delegation to pass a clean, five-year extension of the Children’s Health Insurance Program (CHIP), which provides $454 million for an estimated 325,000 Illinois children enrolled in CHIP. This deadline passed with no action.
The LWVIL signed on to a letter to the Illinois Congressional Delegation to renew CHIP and the Maternal Infant Home Visiting Program. Also signed on to a letter opposing ACA healthcare.gov weekend shutdowns and sh shortened enrollment periods.
Early November the House passed HR 3922 to extend funding for CHIP and Community Health Centers. Ending decades-old bipartisan support for CHIP, the bill adversely affects Medicaid, criteria for coverage, and provisions impacting Illinois children. In addition, the legislation cuts public health services by shifting 75% of Affordable Care Act’s Prevention and Public Health funds to pay for the Community Health Center funding.
A follow up has been sent to once again request a clean extension of CHIP funding, and the federal Maternal, Infant, and Early Childhood Home Visiting Program.
Read the letter under Additional Resources.
ACA CO-OPS (Consumer Operated and Oriented Plans) and Land of Lincoln Health.
The Affordable Care Act (ACA) formed 23 CO-OPs, start up insurance companies backed by federal loans. Land of Lincoln, the Illinois CO-OP, is generating headlines following its shutdown. Some 49,000 subscribers are looking for new coverage by November 1. An additional headache, the new companies require deductible payments to start from scratch in order to provide insurance for the two remaining months. Insurers in some states with failed CO-OPs are waiving this provision. So far, this is not the case in Illinois.
By the end of last year, all but two of the 23 CO-OPs were struggling according to a Commonwealth Report. Currently 7 remain.
Other IL ACA Marketplace Developments
In May United Healthcare dropped ACA plans and Aetna, in early August, pulled out of most ACA exchanges. Effects of this and the Lincoln Land closure remain to be seen, especially in rural communities and areas of the state where services are more fragmented.
Voter AttitudesA July 15 Kaiser Family Foundation survey found that Health Care isn’t high on the list of voter concerns this year. Terrorism scored #1, Candidates’ Personal Characteristics #2. Health Care came in around 37%, close to Gun Control, and Education.
On July 11th President Obama wrote an editorial in the Journal of the American Medical Association on his assessment of the Affordable Care Act.
Relevant health care bills from current legislative session being followed by LWVIL:
HB5576 Contraceptive Coverage Act Ensures access to full range of contraception in all insurance plans, and if patient's care provider prescribes a specific medication or method insurance must provide a 12 month supply without cost sharing.
SB1564 Healthcare Right of Conscience Act Amends the Illinois Health Care Right of Conscience Act to ensure a patient’s right to medically accurate and complete information, even though a provider has religious or moral objections.
These 2 bills have passed both Houses and await the Governor’s signature. LWVIL has sent him 2 separate letters one regarding HB5576 and one for SB1564 requesting his signature. A TFA has been sent asking members to contact the Governor about SB1564.
Current cases before the Supreme Court of the United States:
Zubik et al. v. Burwell. A group of religious non-profits is challenging the HHS accommodation to exempt them from providing contraception in employee health insurance benefits. On May 16th Supreme Court issued an unsigned order asking the courts of appeals to attempt to have the parties work it out.
Whole Women's Health v. Hellerstedt (Formerly Cole) challenges a Texas law imposing new medical regulations on abortion clinics, potentially closing 75% of facilities. The case is one of the most consequential in decades on the future of access to abortion. On June 27th the Court ruled 5-3 that Texas cannot place restrictions on the delivery of abortion services that create an undue burden for women seeking an abortion. The decision may impact similar restrictions on abortion access in other states.
Recently United Healthcare has announced that does not expect to participate in the ACA next year, and some other insurance companies have expressed concern. They are finding participation is not profitable. There had been risk corridors set up to limit insurer gains and losses. Insurers receive a payment from HHS if losses exceed a certain threshold, insurers pay HHS if their gains exceed a certain threshold. However last year Congress (an effort led largely by Senator Marco Rubio) passed legislation that prevented any money beyond collections be paid by HHS.
On May 12th District Court Judge Rosemary Collyer ruled, in a lawsuit by US House Republicans, that the Obama administration illegally spent money that Congress never appropriated for the ACA's cost sharing provisions. Collyer stayed her decision pending an appeal.
Supreme Court of US Current Cases
Zubik et al. v. Burwell. On May 16th the Supreme Court issued an unsigned order asking the court of appeals to attempt to have the parties work out their differences and come to a compromise.
Whole Women's Health v. Hellerstedt (formerly Cole), awaits decision this spring. This case is consequential in the future of access to abortion. Because of Justice Scalia's death the result may be a 4 to 4 split.
LWVIL Bills Current Session:
HB5576 Contraceptive Coverage Act Passed the House on 4/21/16. Sent to the Senate, placed on Calendar order of 3rd Reading on May 18th.
SB1564 Healthcare Right of Conscience Act Passed by Senate 4/22/15, and sent to House 4/22/15. On 4/12/16, had second reading and 4/28 sent to rules committee.
HB5576 Contraceptive Coverage Act - Time for Action sent 4/4/16. Ensures access to full range of contraception in all insurance plans without cost sharing.
SB1564 Healthcare Right of Conscience Act amends Illinois Health Care Right of Conscience Act to ensure a patient’s right to medically accurate and complete information, including a referral, even though a provider has religious or moral objections. Passed by Senate 4/22/15, to House 4/22. Final deadline: 4/28/16
Supreme Court of US Current Cases
A divided Supreme Court issued an order March 30 directing both sides in Zubik et al. v. Burwell to file new briefs to determine the minimum plaintiffs must do in order to pay for contraception. A group of religious non-profits is challenging the HHS accommodation to exempt them from providing contraception in employee health insurance benefits. The court asked both sides to discuss a compromise where contraception could be provided without the groups having to formally object. The court pointed out ways this could occur. Deadline for response is April 20. This unusual order would avoid a 4-4 tie vote, leaving different rules in place across the country since lower courts have issued conflicting rulings.
Whole Women's Health v. Hellerstedt (Formerly Cole) heard March 2, challenges a Texas law imposing new medical regulations on abortion clinics, potentially closing 75% of facilities. The case is one of the most consequential in decades on the future of access to abortion. Currently 13 states have similar restrictions in place.
In Illinois, LWVIL opposed bills filed with restrictions on abortion for the past six years; none came to a vote. Medical professional associations in Texas and nationally, dispute Hellerstedt’s contention that the regulations would ensure the health and safety of women. Rather, the law would be harmful by putting unnecessary barriers to care, pushing an abortion into the second trimester.
Bills followed by LWVIL in IL Legislature:
SB1564 Healthcare Right of Conscience Act amends Illinois Health Care Right of Conscience Act to ensure a patient’s right to medically accurate and complete information, including a referral, even though a provider has religious or moral objections. Passed by Senate 4/22/15, to House 4/22. Final deadline: 4/28/16.
HB5576 IL Contraceptive Coverage Act amends the Illinois Insurance Code, changing section on coverage for contraceptives. Provides individual or group health policy provide coverage for all contraceptive drugs, devices, and other products approved by the USFDA, If the patients care provider recommends a particular service or item, the insurance must provide it without cost sharing. Bill was introduced 2/9/16, LWVIL sent Witness slip 2/24 when it was in Human Services Committee. Placed on Calendar Second Reading. Anticipate TFA, but House not in session again until April 4th.