The Illinois General Assembly passed its Fiscal Year (FY) 2024 budget, including $49.6 billion designated for the general fund.* The budget reflects allocations to the following categories: Human Services (19.7%), Healthcare (18%), Government Services (7.6%), Statutory Transfers (4.0%), Higher Education (4.9%), Public Safety (4.9%), Economic Development (0.6%), PreK-12 Education (20.5%), Pensions (19.5%), and Environment and Culture (0.2%). *General fund expenditures are those that fund the government’s ability to provide services for its residents.
Governor Pritzker’s FY’24 Investment Priorities included social service programs, economic development, and infrastructure. As a result, many bills focused on health care and funding allocations reflect the Governor's and legislators' priorities.
HC3 and its members are committed to reforming the city’s health care ecosystem through three categories:
Addressing health and social disparities
Curating economic development
Catalyzing health system transformation
In terms of addressing health and social disparities, the budget provides:
$38 million for 23 safety net hospitals that serve low-income communities.
$18 million to establish a reproductive health navigation hotline, training, and consultation programs.
$19.3 million to increase staffing by 330 at state DD facilities.
Twelve percent (12%) increase for nursing home support.
$50 million annually to support rate increases for FQHCs.
$2 million for Alzheimer’s disease outreach, research, care, and support.
$50 million increase to Temporary Assistance for Needy Families, including funds to increase the monthly grant payment from 30% of the Federal Poverty Level to 40%.
$2.5 million for the Community Health Worker certification program.
$550 million to fund a program that provides Medicaid-like coverage to certain undocumented individuals.
$8 million for a Ready to Renew Campaign to help Medicaid customers maintain their coverage or transition to other health insurance.
The budget proposal includes over $100 million for Medicaid reimbursement rate increases beginning January 1, 2024.
Ten percent (10%) increase for hospitals.
The budget focuses on addressing health and social disparities by providing funding to expand the Medicaid program, which in turn will expand access to health care as more people are eligible for coverage. The funding also addresses the need to build human capital infrastructure to properly staff facilities such as nursing homes and state facilities for the developmentally disabled population.
Additionally, rate increases –which were long overdue for providers – were a significant legislative win for hospitals and FQHCs. In previous years when the General Assembly was not passing budgets, many providers and organizations could not sustain themselves because of severely delayed payments and low reimbursement rates. This practice caused providers to limit or restrict the acceptance of Medicaid clients, thus reducing access to care. Rate increases reflected in the FY ’24 budget will afford providers the ability to care for clients without economically compromising their practices.
Furthermore, residents who reside in rural parts of the state face significant challenges regarding access. Many communities do not have access to a network of health care providers, and some residents must travel up to 40+ miles to seek medical, specialty, or care in a hospital. The recent announcement of St. Margaret’s Health Hospital closing in southern Illinois and other locations is an example of the “health deserts” that exist throughout rural Illinois.
In terms of addressing economic development, this budget provides:
Funds the Home Services Program with an additional $30.8 million to address growing caseloads and $10 million to support the Paid Leave for All Workers Act within the program.
$3 million for the Equity and Representation in Health Care Workforce loan repayment and scholarship programs.
$2 million for mental health training for front-line workers in the pediatric field.
HFS plans to reinvest approximately $450 million in a multi-year plan to preserve and grow the health care workforce, focusing on Medicaid providers and providers in rural areas and other underserved areas of the state. The significant infusion of revenue will provide funding for training and continuing education for providers and other vital investments in staff retention and recruitment.
$2.5 million for the Community Health Worker certification program.
$24 million for rate increases for home workers who assist the elderly.
Several items to address economic development attempt to create more equity in the health care industry by investing dollars in training, education, and scholarships. Furthermore, the General Assembly appears to understand the importance of representation in health care fields; particularly since there is distrust among the BIPOC communities based on discriminatory and racist experiences of marginalized groups.
In terms of addressing health system transformation, this budget provides:
With $22.8 million in funding approved, state agencies will be able to move forward with system improvements to behavioral health access by building out residential transition and placement, acute crisis care, and intensive in-home and community-based services.
$53.5 million to overhaul the IDPH disease monitoring systems in preparation for future public health emergencies.
$10 million to initiate a state-based health insurance marketplace by the 2026 plan year.
Authority to the IDOI to approve, deny, or modify proposed health insurance rate increases while providing cost transparency for rate changes.
Items to address system transformation indicate a strong commitment to updating antiquated infrastructure and systems that impact health care delivery. Additionally, these items addressed access in creating an additional avenue for residents to acquire coverage and transparency in costs for consumers.
(additional news was previously shared in HC3 Weekly for members only)
Contributors to this post include:
Jordana Choucair, Senior Vice President of Communications, Third Horizon Strategies
Bamidele Odusote, Manager, Third Horizon Strategies
Meghan Philipp, Executive Director, HC3
Chasity Wells-Armstrong, Strategic Consultant to HC3