What's AFC up to in Springfield? 2013 Legislative Session Update

AFC works hard in Springfield to enact sound HIV/AIDS policies. This page contains legislative updates for some of the bills we're working on, information on the state budget, and additional information you can use to assist us in our efforts.

Current Issues (more information after the jump):

• SB 26 - Medicaid for Low-Income, Uninsured Illinoisans - Senator Heather Steans (D-Chicago) and State Rep. Sara Feigenholtz (D-Chicago)
  Allows 342,000 uninsured Illinoisans access life-saving medications and medical care through Medicaid.

• HB 61 - Repeal Principal Notification of HIV Positive Students - Representative La Shawn Ford (D-Chicago) and Senator Iris Martinez (D-Chicago)
  Repeals a law that requires state health departments to notify school principals of HIV-positive students.

• HB 2675 - Comprehensive Sexual Health Education for Illinois Students - Representative Camille Lilly (D-Chicago) and Senator Heather Steans (D-Chicago)
  Requires public schools to provide medically-accurate, age-appropriate, and comprehensive sexual health education

Want to get updates on these issues and more? Sign up for our Online Action Bulletin to receive email updates, lobbying opportunities, and more!

The AIDS Foundation of Chicago (AFC) recently made the difficult decision to oppose legislation that creates a state-federal partnership for operating Illinois’ health insurance marketplace. We base this decision on the poor consumer protections in the bill.

House Bill 3227 (Senate Amendment 2) is backed by our partners, including Campaign for Better Health Care (CBHC), and is sponsored by Sen. Dave Koehler (D-Peoria), a long-time friend of AFC and champion for helping people without insurance access health care. Still, we cannot support it.

The Affordable Care Act (ACA), the new national health care reform program established by President Obama and Congress in 2010, creates online health insurance marketplaces that will allow individuals, families, and small business employees to shop for health coverage. Such marketplaces – which will be comparable to, say, Travelocity for health insurance – are a central component to the success of ACA state implementation. Plans sold on the marketplace will be available to anyone, including people with HIV, regardless of their diagnosis or condition, ending decades of legal discrimination by insurance companies against people with HIV. People earning between about $16,000 and $46,000 will be able to receive subsidies to make premiums and out-of-pocket costs more affordable.

States have the option to operate the marketplace themselves, use a marketplace run by the federal government, or operate a state-federal partnership. In 2014, Illinois will employ the state-federal partnership option and use the federal marketplace as the backbone of its system; however, Illinois will directly operate outreach, enrollment, and other programs. Eighteen states are running their own marketplace; seven, including Illinois, will use a state-federal partnership model; and 27 will exclusively use the federal marketplace. (See the Kaiser Family Foundation's "State Decisions on Health Insurance Exchanges and the Medicaid Expansion" for more information.)

AFC and many other advocates, health care providers, insurance industry officials, brokers, and others believe a state-operated marketplace is best for Illinois. This would allow the state to have the most control over the program and facilitate better coordination with Medicaid, which will cover people earning roughly $16,000 or less.

The ACA will give considerable flexibility to states that operate their own marketplace, allowing them to determine governance and organizational structure, financing, and the ability to establish operational requirements to meet federal standards. These decisions will greatly determine if the marketplace is successful at providing affordable health plans for individuals and small businesses.

HB 3227 would create an Illinois-run marketplace beginning in 2015. The bill created a quasi-government entity to operate the exchange, which would be funded through a tax on the insurance industry.

It’s no secret that the insurance industry has tremendous influence in Springfield. Advocates often joke that consumer-friendly insurance reform bills go to the House and Senate Insurance Committees to die. Moreover, the insurance industry makes significant campaign donations to sitting members of the General Assembly, as detailed in this 2011 State Journal Register article.

The primary reason AFC opposes HB 3227 is that the Illinois General Assembly and its insurance-industry allies would have heavy control over the marketplace. Here are three examples of why this creates an unhealthy system of oversight: 1) the General Assembly would annually approve the budget for the exchange, even though its operating funds are held outside the state treasury; 2) the General Assembly would control even small details, such as the executive director’s salary; and 3) language in the bill limits the exchange’s ability to impose future standards that are more rigorous than the minimums established by the federal government.

Giving significant control of the exchange to the General Assembly is akin to letting the fox design, build, stock, and guard the henhouse. If us chickens are to have a meaningful choice of affordable insurance plans that provide high-quality health care, the exchange needs more independence from the General Assembly and by extension, the insurance industry.

We favor an independent marketplace board of directors that includes strong consumer and small business members, not insurance industry representatives. A board with these standards and statewide representation will be vested in making the best decisions for Illinois health insurance consumers.

In addition, AFC is concerned that the marketplace bill has the potential to leave people with HIV vulnerable to health insurance companies. For example, federal law requires insurance plans to contract with “essential community providers,” which include medical clinics funded by the Ryan White Program. This requirement makes sure people with HIV don’t have to switch health care providers and can obtain high-quality HIV care; however, AFC is concerned that health plans might exclude Ryan White Program providers in order to drive away people with HIV—a potentially discriminatory practice.

Moreover, the Illinois bill simply references the federal standards for navigators, which are weak and contain no numerical standards:

§ 156.235 Essential community providers. (a) General requirement. (1) A QHP issuer must have a sufficient number and geographic distribution of essential community providers, where available, to ensure reasonable and timely access to a broad range of such providers for low-income, medically underserved individuals in the QHP’s service area, in accordance with the Exchange’s network adequacy standards. (45 CFR 156.235)

Under the federal-state partnership marketplace that will roll out in 2014, a different set of federal rules requires that plans contract with at least 20 percent of essential community providers in their service area. If they cannot meet that standard, they must submit a written statement, explaining their shortcoming and how they will make sure the network is adequate (see page 7 of this letter to issuers on federally-facilitated and state partnership exchanges). Although we earlier argued that this provision is also weak, we think the specific 20 percent requirement is better than the federal requirement Illinois would follow under HB 3227.

HB 3227 passed the Senate Insurance Committee on May 9 by a vote of eight to five. Tellingly, the Illinois Governor’s Office position was “neutral,” meaning they neither supported nor opposed the bill. The bill awaits a vote in the full Senate, and then must proceed to the House. It’s too soon to predict if the measure will advance in the House by the end of the session on May 31.

Meanwhile, the marketplace, run by the state-federal government, will begin enrolling Illinoisans beginning on October 1, 2013, for coverage starting January 1, 2014.

If HB 3227 does become law, AFC will work to influence regulations to favor consumers, and of course, we will advocate in future General Assembly sessions to improve the law for people with HIV, as well as other vulnerable populations.

HIV BUDGET CENTRAL

What’s going on in Illinois? … On March 6th, 2013, Governor Pat Quinn proposed a budget for 2014 that would reduce state  funding for HIV/AIDS services from $26 million to $21 million, a 16 percent cut.

Learn more about the funding cut to HIV services here, and how you can TAKE ACTION against it!

ACLU-IL, AFC, and Planned Parenthood Support Landmark Measure

Media contact for ACLU-IL: Edwin Yohnka (312-201-9740, ext. 305 / This e-mail address is being protected from spambots. You need JavaScript enabled to view it )

Media contact for AFC: Ramon Gardenhire (301-379-3024 / This e-mail address is being protected from spambots. You need JavaScript enabled to view it )

Media contact for Planned Parenthood: Lara Philipps (312-592-6820 / This e-mail address is being protected from spambots. You need JavaScript enabled to view it )

The Illinois House of Representatives passed a comprehensive sexual health education bill (HB 2675) today in a vote of 66 to 52.

The American Civil Liberties Union of Illinois (ACLU-IL), Planned Parenthood of Illinois, and the AIDS Foundation of Chicago (AFC) played a major role in moving this legislation forward, which was sponsored by Rep. Camille Lilly (D-Chicago).

“This is a good day for young people in the state,” said Khadine Bennett, legislative counsel for ACLU-IL. “Thanks to Rep. Lilly’s leadership, public school students in grades six to 12 are one step closer to receiving age-appropriate sexual health education.”

“The General Assembly moved closer to providing students in Illinois access to information to make responsible decisions about their sexual health,” said Ramon Gardenhire, director of government relations for the AIDS Foundation of Chicago (AFC). “We are tremendously grateful to Rep. Lilly for the leadership she displayed on getting this bill passed through the House.”

“The goal of any top quality sexual health education program should be to help young people make responsible, healthy decisions,” said Carole Brite, Planned Parenthood of Illinois President and CEO. “Today we are pleased that sixty-six members of the Illinois House voted to ensure that teens in Illinois have access to medically accurate, age appropriate, comprehensive sex education. Studies show that sex education that covers contraception and disease prevention results in teens who are more likely to delay sexual activity and use protection when sexual activity does occur. This bill is a huge step forward in advancing the health and safety of young people in Illinois—while they are teenagers and throughout their adult lives—and we look forward to thoughtful consideration by the Illinois Senate.”

“As the discussion on the House floor made clear, it was time for us to modernize the basic curricula in Illinois for teaching sexual health education,” said Rep. Lilly. “If this measure becomes law, public school curricula will provide young people with tools and information necessary to grow and mature in a safe and healthy fashion. I am so proud to have been part of this effort.”

Next, the bill heads to the Senate, where it will be sponsored by Sen. Heather Steans (D-Chicago). A nearly identical measure passed the Senate in 2011 but was never called for a vote in the House.

HB 2675 creates a standard for existing sexual health education courses in grades six through 12; provides medically accurate, age-appropriate, complete information on reducing sexually transmitted diseases and infections, as well as unintended pregnancies; ensures that local school districts can choose curricula that meet their community’s standards; and allows for parents to remove their children from sexual health education courses for any reason without penalty to their child.

“We urge the Senate to act as soon as possible to move this important measure forward,” Bennett said.

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The American Civil Liberties Union of Illinois is a non-partisan, non-profit, membership organization dedicated to protecting and extending freedom, liberty and equality to all in the United States.
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Founded in 1985 by community activists and physicians, the AIDS Foundation of Chicago is a catalyst for local, national, and international action against HIV/AIDS.
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Planned Parenthood of Illinois (PPIL) provides affordably-priced, high-quality reproductive health care services to women and families throughout Illinois. Through health care services, educational programs and advocacy efforts, PPIL works to ensure and protect the reproductive rights of each individual. For more information, visit www.ppil.org.

The AIDS Foundation of Chicago (AFC) applauds President Barack Obama’s 2014 fiscal year budget proposal, which preserves federal funding for essential AIDS-related care, prevention and housing services and dismantles the harmful discretionary funding cuts known as “sequestration.”

“Under sequestration, low-income Americans will experience devastating cuts in health and safety-net services needed for basic survival,” said David Ernesto Munar, AFC President/CEO. 

“We applaud the President’s plan to repeal and replace sequestration with manageable budget control provisions,” Munar continued.  “If allowed to move forward, sequestration will pit essential AIDS programs against other vital programs and services for a significantly smaller amount of federal funds.  The impact on the nation’s overall budget would be marginal – but have no doubt, the consequences for low-income Americans would be exceedingly harsh.”

“We thank President Obama for continuing to recognize the importance of the Ryan White Program by providing level funding for most of the program, and a $20 million increase for the AIDS Drug Assistance Program and HIV clinics,” said John Peller, Vice President of Policy. 

“The Affordable Care Act will meet the basic HIV health care needs of people with HIV beginning in 2014. And the Ryan White Program will continue to play  a central role by completing ACA coverage with vital services such as housing, food and nutrition, legal services, and case management for highly vulnerable people with HIV.” 

There is substantial evidence that people with HIV who receive complete coverage in addition to medical care and medications are better able to adhere to medical treatment.  Improved adherence improves health outcomes, lowers medical costs, and reduces the risk that people with HIV will transmit the virus to their partners.

Details of the President budget plan include:

•    Sustained funding levels for Ryan White HIV/AIDS services, including a $10 million proposed funding increase for the AIDS Drug Assistance Program and a $10 million proposed increase for HIV/AIDS clinics funded through Part C of the Ryan White Program
•    Sustained funding levels for HIV/AIDS prevention services at the U.S. Centers for Disease Control and Prevention (CDC), with a $14 million proposed increase
•    Sustained funding levels for the Housing Opportunities for People with AIDS (HOPWA) program, and a modernized funding formula that would better reflect the current housing needs of people with HIV
•    Increased HIV-related funding for the National Institutes of Health and Veterans Administration

The Republican-led House  passed a budget plan earlier this year that would drastically reduce HIV and other safety-net services beginning as early as 2014.  As the House begins review of the President’s requested appropriations, members are likely to call for radically lower funding levels than those sought by the President.

Stay tuned for more information on the federal budget, including ways you can advocate for adequate and appropriate funding for these and other vital services our communities need.

A bill for comprehensive sexual health education in Illinois (HB 2675) moved out of House Human Services committee on March 13 by a vote of 9-6 and awaits a full House vote.

The AIDS Foundation of Chicago (AFC) is part of a statewide partnership that has been advocating heavily for this legislation for four years.

“We’ve lobbied on it, engaged lawmakers, written articles, held town-hall meetings, and published op-ed articles to gain support for this important piece of legislation,” said Ramon Gardenhire, Director of Government Relations at AFC.

HB 2675 aims to modernize Illinois’ sex education law and create a standard for existing sexual health education courses and would require existing sex education programs to teach complete, medically accurate, and developmentally and age-appropriate content. The bill would require school districts that choose to teach sex education to include instruction about abstinence and contraception, as a means of preventing pregnancy and sexually transmitted diseases (STDs), including HIV/AIDS.

The bill, if enacted, wouldn’t require every school or classroom to teach sex education; it would require those that do to adopt a comprehensive approach. HB 2675 ensures more uniformity in what is being taught across the state, by codifying that educators use medically accurate, age appropriate, complete information.

Currently, sex education is not required in Illinois. But school districts that include it in their curricula must teach abstinence. Individual school boards can decide to incorporate lessons on birth control and contraception—but they don’t have to. “This approach might encourage young people to refrain from having sex until marriage, but it’s inadequate,” said Evany Turk, an advocate for the Illinois Alliance for Sound AIDS Policy.

“Abstinence hasn’t worked because there are a lot of high school students who are pregnant,” Turk said. “A lot of high school students are still contracting STDs and STIs [sexually transmitted infections], and the numbers show that these diseases are on the rise, which proves abstinence-only education does not work.”

She also noted that HIV has increased recently among people 16 to 24.

The AIDS Foundation of Chicago (AFC) submitted on March 27, 2013 comments to the Illinois Department of Insurance (DOI) on the standards insurance plans must meet to be included on the Illinois Health Insurance Marketplace.

The marketplace (also known as the exchange) will be an interactive website that will allow individuals and small businesses to purchase more affordable private health insurance. The marketplace was established by the Affordable Care Act (ACA), the national health care reform law.

AFC raised several specific issues:

• DOI should not allow plans to charge unreasonably high cost-sharing for HIV medications.
• DOI should clarify how health insurance plans should submit data about coverage of combination HIV medications. DOI's proposals would allow plans to include combination medications under several categories, making it difficult for DOI to determine if coverage is sufficient to meet the needs of people with HIV.
• DOI should make sure plans include robust networks of safety-net providers, including agencies funded by the Ryan White Program. One proposed standard, which AFC deems unacceptable and urged DOI to delete, would allow plans to include less than 20% of safety-net providers in an area.  Under this unacceptable standard, plans would not be required to offer contacts to any Ryan White Program providers.

DOI is expected to release final guidelines on Monday, April 1.  Insurance companies must submit proposed plans by April 30.

Read AFC's full comments (PDF)

Read the draft DOI standards (PDF)

HIV/AIDS advocates from across the United States gathered in Washington D.C. this past February to partake in AIDSWatch 2013, the nation’s largest annual constituent-based federal advocacy event. Thanks to the Treatment Access Expansion Project and AIDS United, it was an invigorating two days. In total there were 200 legislative meetings and 170 attendees!

The AIDS Foundation of Chicago sponsored nine advocates to represent the state.  Illinois held 11 successful meetings, featuring Sen. Durbin and Sen. Kirk, as well as Congressional Freshman: Rep. Davis, Rep. Foster, Rep. Duckworth and Rep. Enyart.

It was an exciting time to be on Capitol Hill, but it was an incredible time for HIV/AIDS advocates to improve the health and lives of people living with HIV and to reduce new infections. The passage of the Affordable Care Act (ACA) and the adoption of the National HIV/AIDS strategy in 2010 marked significant milestones in changing the course of this epidemic. The mission of AIDS Watch 2013 was to educate members of congress and ask them to support three important HIV/AIDS issues this congressional session: 1) Protect, fund and support effective implementation of the ACA; 2) support the vital role of the Ryan White Program and other HIV/AIDS services; 3) and support science over politics.

Alongside legislative issues, Illinois delegates shared personal stories to pack an even greater congressional punch. When advocating to protect HIV services, a constituent from Decatur, Ill., bravely told her U.S. Congressman how Ryan White Programs saved her life. She would not be sitting in his office right now without such a vital network of care, she said, and protecting these funds was critical for her and hundreds of thousands of others living with HIV/AIDS.

AIDSWatch 2013 brought together a united front of HIV/AIDS advocates in a time of great hope for the epidemic. First year AIDSWatch participant Chris Wade from Illinois concluded, “To be a part of a national event was inspiring, and the sense of camaraderie among people living with HIV/AIDS was enlightening!”

You can see more pictures of the AIDSWatch 2013 event on AIDS United’s Facebook page.

Leaders from Illinois Department of Public Health on March 11, 2013 provided an update on proposed FY 14 state funding for IDPH and the funding outlook for HIV programs.

Overall, the news was mixed.  While state general revenue funding for HIV programs has declined significantly over the past three years, IDPH has obtained new sources of state funding, such as the Quality of Life Lottery and African American HIV/AIDS Response Fund, that have somewhat blunted the impact of other reductions. In addition, Illinois has received increased federal funding that has also helped to reduce the strain on the state budget, but this new funding has not been a fully replaced state budget cuts.

In response to the state budget proposal that reduces HIV funding by $4.3 million, AFC urged lawmakers to retain funding in the budget and pass SB 26.

IDPH budget overview by Gary Robinson

HIV Section budget overview by Dr. Mildred Williamson (PDF)

Passage of HB 61 will encourage HIV testing among teens at risk of HIV

ALCC media contact: Ricardo Cifuentes 312 427 8990
This e-mail address is being protected from spambots. You need JavaScript enabled to view it

AFC media contact: Ramon Gardenhire, 301-379-3024                       
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The effort to repeal Illinois’s outdated HIV principal reporting law took a major step forward this afternoon when the Illinois House of Representatives voted 61-55-1 in support of Representative La Shawn Ford’s HB 61, which repeals the principal notification sections of Illinois’ Sexually Transmissible Disease Control Act.  The bill next moves to the Senate.  

“Rep. Ford has sponsored this bill for the past five years, and his leadership and persistence have finally paid off,” said Ann Fisher, executive director of AIDS Legal Council of Chicago (ALCC).  “AIDS Legal Council of Chicago and AIDS Foundation of Chicago (AFC) are grateful for Rep. Ford’s support and thank his colleagues in the House who voted for the bill.”