Thursday, April 17, 2025
The head of Illinois’ Medicaid agency told lawmakers Wednesday that they plan to proceed with several key health initiatives, even as there is uncertainty about federal support for such programs.
Specifically, Department of Healthcare and Family Services Director Elizabeth Whitehorn said they are focused on behavioral health initiatives like the Medicaid demonstration program that supports facilities who provide comprehensive, around-the-clock behavioral healthcare and substance abuse treatment.
Nineteen mental health and substance use treatment providers are part of the initial Certified Community Behavioral Health Clinics program, with additional providers expected to be added later.
Officials said the program, which combines state funding with an enhanced federal match, will boost Medicaid by $150 million.
“We’re continuing to build out significant care coordination services as well as some new community services that were not previously available in Illinois,” Whitehorn told members of the Senate’s Appropriations – Health and Human Services Committee. “So we got a lot going on behavioral health.”
Other initiatives include implementing recommendations from an advisory council on ways to support access to sickle cell disease treatment and other high-cost drugs and treatments and announcing the latest round of medical debt relief.
Whitehorn added that they will continue to lay the “groundwork for the long-term success of our 1115 healthcare transformation waiver.”
The hearing comes as agency officials said they continue to worry about the potential ramifications of federal cuts to the Medicaid program.
Whitehorn said they are concerned that 770,000 Illinoisans could lose coverage if Congress cuts the Affordable Care Act’s Medicaid expansion. Illinois currently contributes $750 million to cover that population, with the federal government contributing $7.5 billion.
Specific cuts or changes to the program have not been formally introduced, but Whitehorn said reported changes would all lead to some decline in enrollment or benefits.
A per capita cap to limit federal Medicaid funding to states could cause Illinois to lose between $24 and $39 billion over 10 years.
Whitehorn said between 344,000 and 633,000 Illinoisans could lose coverage if work requirements are implemented. She said some of those would be due to administrative burdens, such as filing necessary paperwork in a timely fashion.
Another idea floated is to change provider taxes, which states use to help fund the program. The state will collect over $3.9 billion in assessments on hospitals, nursing homes and managed care organizations this fiscal year.
“These proposed cuts would have a massive impact on our ability to fund the number of customers and the services we currently do, because, as I said before, the state is simply unable to pick up the amount of federal funding that would be lost,” Whitehorn said.
In other business, Whitehorn said they are in the process of procuring new contracts for Medicaid managed care organizations. Proposal requests will be released this summer, with the contracts to begin in 2027.
She said the agency’s goals for the new contract are to “significantly address” health disparities, improve care coordination and network adequacy, value-based care and improve relationships among customers, providers, MCOs and vendors.
Whitehorn also reiterated they are working with stakeholders to prepare for the sunset of a program that provides Medicaid-like coverage for undocumented individuals between 42 and 64 years old.
The program will close at the end of June unless lawmakers allocate funding to continue it. Gov. JB Pritzker’s proposed $55.2 billion spending plan zeroes out funding for the program.
She told lawmakers they are working with providers that serve the population, like Federally Qualified Health Centers hospitals and free and charitable clinics, to help direct individuals to available resources.
“We have been trying to work with as many stakeholders as we can, because we know this is going to be a difficult transition process,” she said.
The program covered 32,827 individuals as of February.