Whitehorn updates lawmakers on 1115 waiver status

Department of Healthcare and Family Services Director Elizabeth Whitehorn told lawmakers last week they hope to receive federal approval of the state’s 1115 waiver targeting the social determinants of health and behavioral health by this summer.

She told members of the House’s Appropriations-Health & Human Services Committee that they are meeting weekly with officials from the Centers for Medicare and Medicaid Services. While they have not been given a timeline, they hope for an answer by the end of June.

“They told us they are also understaffed and have said they might need a little bit more time, but we are pushing diligently,” she said.

Once approved, HFS expects to spend half a year working with federal partners on operational protocols and the implementation plan.

Whitehorn said they’ll also have to set up billing systems and other protocols with organizations “who are not traditional Medicaid providers.”

Additionally, she said they do not have to “open it all up at the same time,” with some programs opening in phases.

In other business, she said they are working on legislation for the $10 million Gov. JB Pritzker’s administration hasproposed in the upcoming budget to help eliminate medical debt for 340,000 low-income Illinoisans.

Specifically, Whitehorn said they are working on the provision related to what groups would qualify for loan forgiveness.

Several lawmakers suggested that HFS keep in mind those in the middle class, who are just as likely to be put into financial ruin by medical debt as those with lower wages.

“I do want to recognize the families that are on the bubble,” said Rep. Terra Costa Howard, D-Glen Ellyn. “I do think we need to be very cognizant of this working for those people.”

Whitehorn also told lawmakers they continue to look at cost savings in the programs that provide Medicaid-like coverage for some undocumented adults.

The agency previously said it would begin verifications this month for those in the programs, which serve individuals between the ages of 42 and 65 and enrollees 65 and older. Those found ineligible will be removed from the programs by July 1.

Copays and coinsurance for undocumented individuals in the programs returned earlier this year. They apply to the use of non-emergency hospital or surgical center services, like elective surgeries, physical therapy and lab work.

Whitehorn reiterated they have no current plans to reopen enrollment for the programs.

House passes plan on nurse licensure, other bills

The Illinois House approved several healthcare proposals ahead of the chamber’s Friday deadline to pass bills to the Senate.

That includes a proposal by Rep. Terra Costa Howard, D-Glen Ellyn, that would create an automatic licensing program for advanced practice registered nurses, licensed practical nurses and registered nurses within the Illinois Department of Financial and Professional Regulation system that have met certain criteria, like graduating from an approved program or school and passing a background check and the necessary licensing exam.

Costa Howard said that while the state agency continues to work on updating its software to improve the healthcare licensing process, lawmakers must do more.

“(This bill) is a step in the right direction,” she said.

The House also approved a plan from Rep. Lindsey LaPointe, D-Chicago, that would establish a working group within the Office of the Chief Behavioral Officer to look at the administrative burden that faces behavioral health workers in the Medicaid program.

Another approved LaPointe bill would set minimum reimbursement from private insurers for in-network mental health and substance use disorder, which she said will put behavioral healthcare on par with physical healthcare.

The chamber also signed off along party lines on a bill by Rep. Kelly Cassidy, D-Chicago, that aims to strengthen protections for abortion providers and patients. She said it moves current protections for providers into an existing state law protecting access to reproductive healthcare, with additional protections expected in a later amendment.

The goal, she said, is to help respond to proposals other states approve “that might interfere with our ability to provide that care.”

Other proposals approved would:


  • Require county-operated nursing homes to provide safety-net impact statements before the discontinuation of services or closure.
  • Require the state’s nursing assistant certification exam to be offered in both English and Spanish.
  • Require health insurance policies to cover at-home pregnancy tests when prescribed by a doctor.