OP-ED: Revamping of Health Law Could Be Costly to Illinois

As Congress prepares to replace the Affordable Care Act, it is essential that the Medicaid expansion provision of the law be protected.

Any rollback of federal Medicaid coverage would be particularly harmful to Illinois, especially as our state grapples with budget deficits, an opioid epidemic, and an overburdened criminal justice system.

Under the ACA, Illinois was among the majority of states that expanded Medicaid, which provides federally-funded health insurance for low-income people. In a January letter to congressional leaders, the Rauner administration expressed concern about potential changes to Medicaid, pointing out that 3.2 million Illinoisans—almost one-quarter of the state’s population—are enrolled in coverage. 

Reducing Medicaid coverage would deprive Illinois of millions of dollars per year in federal support. As an example, in behavioral health services alone, the state would have to replace an estimated $80 million per year in federal Medicaid resources to pay for community-based substance use and mental health services that would support alternatives to incarceration and reentry initiatives.

Second, such changes would fly in the face of efforts to address the opioid epidemic that is devastating Illinois communities. Nineteen Illinois sheriffs, prosecutors, and police chiefs recently signed a letter to Congress urging action against any policy changes that would make it even harder for low-income individuals to access addiction and/or mental health treatment. Lack of treatment access impairs law enforcement’s ability to prevent overdose deaths and to make our communities safer.  

Finally, rolling back Medicaid coverage would hamstring Illinois’ successful bipartisan progress toward reforming the criminal justice system. Coverage for addiction and mental health services is essential to the state’s strategy for preventing crime, reducing recidivism, and avoiding the $41,000 per person annual average cost of incarceration for those whose non-violent offenses stem from untreated health conditions.

It is well recognized that there are aspects of the Affordable Care Act that must be overhauled. However, as changes are made, and to expound on what the Governor’s administration and criminal justice experts have written, it would be foolhardy and counter-productive if those changes include an attack on Medicaid coverage. Illinois can ill afford such a loss.

Pamela F. Rodriguez, President & CEO of TASC

TASC President Pam Rodriguez


Pamela F .Rodriguez is president and CEO of Treatment Alternatives for Safe Communities (TASC, Inc.) and a member of Governor Rauner’s Illinois State Commission on Criminal Justice and Sentencing Reform.

TASC Releases Medicaid Policy Briefs, Offers Financing Strategies to Improve Community-Based Healthcare Access for Criminal Justice Populations

(Chicago) – Recent Medicaid policy reforms present new opportunities to improve community-based healthcare access for people under justice and corrections supervision. Access to care is critical to reducing recidivism, given high rates of substance use, mental illness, and chronic medical … Continue reading

Sheriff Tom Dart, Bill O’Donnell Receive TASC Leadership Awards; Access to Healthcare and Recovery Highlighted at Annual Event

(Chicago) – TASC held its 2015 Leadership Awards Luncheon on December 10, honoring Cook County Sheriff Tom Dart and entrepreneur Bill O’Donnell for their advocacy on behalf of people with mental health and substance use disorders.

“Sheriff Dart has called national attention to the injustice of using county jails to house people with mental health conditions,” said TASC President Pam Rodriguez in presenting TASC’s Justice Leadership Award. “He has supported Medicaid enrollment and other activities to ensure continuity of care for people detained at the Cook County Jail.”

To the applause of more than 300 guests at the Westin Michigan Avenue in Chicago, Dart reported that 12,000 people have successfully signed up for insurance at the jail via the Affordable Care Act (ACA). “People who never had insurance now have insurance,” he said. “It is absolutely amazing what this collective work has done.”

Since 2013, the Cook County Sheriff’s Office, working with TASC and the Cook County Health and Hospitals System, has enabled individuals detained at the jail to apply for health insurance. Prior to the expansion of Medicaid under the ACA, the vast majority of people entering U.S. jails lacked insurance, hindering their access to treatment for chronic substance use and mental health conditions that often contribute to rearrest.

The prevalence of these conditions in the justice system is not new, Dart observed. “These are issues that have been around for a while. And it’s with partnerships, working with TASC, that we’ve been able to make incredible change.”

TASC Public Voice Award Recipient Bill O’Donnell noted that he might well have gone to jail for his behavior while he was in the throes of addiction. Coming from a family driven to “achieve, achieve, achieve,” O’Donnell was a successful businessman who became addicted to alcohol and cocaine in the 1970s.

“It wasn’t until I got into treatment the second or third time… that I ever asked myself the question, ‘Why is it that I even need the marijuana, the booze, the coke, to change the way I felt?’” O’Donnell recalled. “Recovery and life and awareness is an inside job. You get can get help, you can get direction, you can get love, you can get guidance—but it’s an inside job.”

O’Donnell went on to found Sierra Tucson in 1983, an internationally-recognized treatment center that was among the first to involve family members in the recovery process.

TASC Executive Vice President Peter Palanca praised O’Donnell for his openness and high-profile voice for recovery. “Twenty-three million are in long-term recovery in this country and it’s still the most stigmatized illness,” said Palanca. “Bill was one of the first corporate leaders to speak openly about his addiction. He is a powerful voice for recovery.”

The value of helping one another was highlighted in two videos accompanying speakers’ remarks. Dart introduced a video depicting personal stories of people who now have health insurance thanks to enrollment efforts at the jail, and Rodriguez presented a video featuring participants in Winners’ Circles, which are peer-led recovery support groups for people who have been involved in the justice system.

TASC has been engaged in initiatives at the intersection of health and social justice since 1976, explained TASC Board Chair Cecil Curtwright. “I believe that our highest human calling is to help others—directly, if possible, and if not possible, to support those who do, with whatever means and talents available to us,” said Curtwright, who is the associate vice provost for academic and enrollment services at the University of Illinois at Chicago.

Among other dignitaries attending TASC’s event were previous honorees, including Gino DiVito, retired appellate court justice; Melody Heaps, TASC founder and president emeritus; and Toni Preckwinkle, president of the Cook County Board of Commissioners.

Chairing TASC’s 2015 event committee was John Zielinski, vice president and financial advisor at William Blair, who, along with other volunteers and generous donors, guided TASC’s most successful fundraising campaign to date. Zielinski extended special thanks to Blue Cross and Blue Shield of Illinois, the presenting sponsor of the event, along with numerous other generous sponsors and raffle prize donors.

“TASC is successful because we work together,” said Rodriguez. “Thanks to science and treatment parity, thanks to the Affordable Care Act and the efforts of TASC and our community partners, and especially thanks to all of you, more and more men and women are finding the treatment, the support, and the hope and tenacity needed to build and strengthen those delicate roots into lifetimes of recovery.”

TASC 2015 Leadership Awards Luncheon. Left to right: TASC Board Chair Cecil Curtwright, Justice Leadership Award Honoree Tom Dart, Public Voice Leadership Award Honoree Bill O'Donnell, TASC President Pam Rodriguez. Photo by Uk Studio.

TASC 2015 Leadership Awards Luncheon in Chicago. Left to right: TASC Board Chair Cecil Curtwright, Justice Leadership Honoree Tom Dart, Public Voice Leadership Honoree Bill O’Donnell, TASC President Pam Rodriguez.

Supporters filled the Westin Michigan Avenue ballroom for TASC's 2015 Leadership Awards Luncheon. Photo by Uk Studio.

Supporters filled the Westin Michigan Avenue ballroom for TASC’s 2015 Leadership Awards Luncheon. Photos by Uk Studio.

TASC VP, Experts Spotlight Prevention, Treatment Funding at Illinois House Heroin Hearing

TASC Executive Vice President Peter Palanca testifies before House Task Force on Heroin Crisis (photo: David Ormsby)

TASC Executive Vice President Peter Palanca testifies before the Illinois House Task Force on Heroin Crisis (photo: David Ormsby)

(Chicago) – A top TASC official, a local prosecutor, and health experts sent a clear message to lawmakers at an Illinois House heroin hearing this week: prevention and treatment funding are a priority.

The new House Task Force on Heroin Crisis held its first hearing in Chicago on Tuesday and took testimony from health and criminal justice experts, including TASC Executive Vice President Peter Palanca.

House task force members present at the hearing – State Reps. Lou Lang (D-Skokie), who chairs the panel, Patricia Bellock (R-Hinsdale), Dan Brady (R-Bloomington), Mary Flowers (D-Chicago), Esther Golar (D-Chicago), and Chris Welch (D-Hillside) – heard witnesses testify on multiple dimensions of Illinois’ heroin crisis. In addition to treatment and prevention funding, testifiers highlighted the science of addiction, describing it as a “medical disease,” and cited the law enforcement challenge of stopping illegal drug sales happening by way of pre-paid mobile phones that lack owner identification.

DuPage County Coroner Dr. Richard Jorgensen, a former emergency room surgeon, explained to legislators the medical impact of heroin on the brain and stressed how the drug’s purity has intensified. He also issued an alarm about the over-prescription of opiate painkillers.

Of those who become addicted to heroin, he said, “Most people become addicted through prescription drugs, and then turn to heroin because it’s cheaper.”

Additionally, Jorgensen emphasized that heroin use is a medical issue, not a criminal justice issue.

“You can’t criminalize your way out of this epidemic,” said Jorgensen. “I really believe that all the prevention dollars that you put in come back many times over.”

TASC’s Palanca bluntly told the committee that solutions are well known and need to be implemented. “The solutions aren’t rocket science and they need to be brought to scale,” said Palanca. “Those solutions include use of proven medications, evidence-based treatment, and prevention.”

Lang told Palanca that the task force plans on leaning on his organization’s expertise.

“We know because of the history of your fine organization that you have a lot to offer us,” said Lang.

Dr. Joseph Troiani, director of Behavioral Health Programs for the Will County Health Department, pointed to the heavy budget cuts inflicted on Illinois’ drug prevention and treatment programs, noting that prevention funding has been cut 88% and drug treatment more than 40% since 2009.

Troiani also stressed that Medicaid expansion under the Affordable Care Act provides an opportunity to expand treatment services, but warned that the issue of capacity – building facilities – needs to be addressed, saying that capital funding for bricks and mortar is critical.

Following testimony by Dr. Seth Eisenberg, medical director for the Illinois Department of Human Services’ Division of Alcoholism and Substance Abuse, Lang asked Eisenberg to “provide to this committee your ideal budget. We know there’s been a cut. What would it take?”

Also testifying at the hearing were Will County State’s Attorney James Glasgow, Cook County State’s Attorney’s Narcotics Prosecution Bureau Chief Brian Sexton, and April Marin and Cassandra Wingert, family members of heroin overdose victims.

Marin testified that her 20-year-old son, whom she suspects was trying heroin for the first time, had typed into Google just days before he died from an overdose, “How much heroin can you safely snort?”

Marin has made it her mission to promote intervention, education, and prevention, entreating legislators for their support.

New Illinois Law Clears Hurdle to Health Care Access Upon Exit from Incarceration

(Chicago) – As a means to reduce recidivism and stabilize communities, the availability of reliable health care upon release from jail or prison is a crucial dimension to any community reentry strategy. In particular, ready access to medications and services that treat mental illness and addiction are critical for preventing a return to criminal behavior.

This year, the Illinois General Assembly and Governor Pat Quinn took a key step to ensure that individuals may continue their care uninterrupted when they transition from jail or prison back to the community. House Bill 1046, sponsored in the House by Representative Greg Harris (D-Chicago) and in the Senate by Senator Mattie Hunter (D-Chicago), allows for incarcerated individuals to begin the process of applying for Medicaid coverage when there are more than 30 days remaining before their release, so that coverage could be effective once they are released from prison or jail.

The bill, signed into law by Governor Quinn on August 2, addresses an inadvertent gap in health care coverage that occurs between incarceration and return to the community. Prison and jail medical care is covered by corrections budgets, but upon release, individuals must have either private or public insurance (i.e., Medicaid) to continue their health care in the community.

The new law amends a 2010 measure, PA 096-0872, which allows individuals to apply for medical assistance 30 days before release. However, due to the length of time it typically takes to complete the application and enrollment process, the 30-day-limit became an obstacle to care rather than a means to achieve the intended goal, according to TASC President Pamela Rodriguez.

“Because of the lag time in completing the enrollment process, individuals with mental health issues and other serious behavioral health conditions are being released from incarceration without having access to needed medications and treatment upon release,”  explained Rodriguez. “The 2010 law inadvertently stopped short of ensuring access to care, as was intended.”

The John Howard Association and TASC’s Center for Health and Justice worked together in advocating the measure, thus bringing the 2010 law in line with its intent.

The new law, PA 98-0139, which was approved with overwhelming bi-partisan majorities in both chambers, allows the Illinois Department of Health and Family Services, the Illinois Department of Human Services, and the Illinois Department of Corrections to develop administrative procedures for an application process that specifically fits within jail and prison environments.

Rodriguez stressed that the law grants no new benefits to formerly incarcerated individuals.

“The new law neither affects an individual’s eligibility for medical assistance, nor does it grant medical coverage while an individual is incarcerated,” said Rodriguez. “Instead, it connects people with community health services that reduce the likelihood of crime and recidivism, and it increases their ability to conduct independent and productive lives.”

Twitter @TASC_CHJ

New Report: Illinois Medicaid Cuts Could Cost Illinois 25,000 Jobs

(Springfield, IL) – Two health-care advocacy groups are predicting thousands of job losses and billions of dollars in economic damage to Illinois, if Gov. Pat Quinn’s plan to conjure $2.7 billion in savings from the Medicaid program is implemented.

Quinn’s plan would jeopardize 25,615 jobs and cost the state’s economy $3.2 billion, according to a report released Wednesday by the Illinois Hospital Association, which lobbies for Illinois hospitals, and the Campaign for Better Health Care, an organization that advocates for health-care access

“Drastic Medicaid cuts hurt everyone, not just the Medicaid patients. Hospitals will be forced to reduce jobs. Local businesses will be impacted,” Illinois Hospital Association President Maryjane Wurth said.

“And hospitals will be forced to cut or eliminate medical services that everyone uses — there is not a separate set of staff, equipment and facilities just for Medicaid patients.”

Quinn’s proposal reduces the amount Medicaid providers get paid by $675 million, accounting for 25 percent of the $2.7 billion in savings.

Nearly every dollar of the $6.6 billion the state spends on Medicaid goes to providers. Cutting provider reimbursement’s by $675 million translates into an across the board rate reduction of 7 percent to 9 percent for providers, according to Quinn spokeswoman Brie Callahan.

Callahan said that in the end it wouldn’t be a blanket rate cut. Some providers would see rates reduced by more than 9 percent, while others might avoid a rate cut all together.

“That still is something that’s being worked out,” Quinn spokeswoman Brooke Anderson said. “These are tough choices, but the reality is that (the) entire Medicaid system will collapse, which would be far worse, if we do nothing.”

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