SPRINGFIELD, Ill. — The Department of Healthcare and Family Services (HFS) has filed emergency and regular rules for the Health Benefits for Immigrant Adults (HBIA) and Health Benefits for Immigrant Seniors (HBIS) programs.
These new rules establish the process the Department will use to determine if and when to alter the program, and how the Department will provide public notification of the alterations.
HFS will follow the process laid out in the emergency rules to temporarily pause new enrollments in the Health Benefits for Immigrant Adults program, which covers eligible residents between the ages of 42 to 64 starting July 1.
This pause does not impact current HBIA enrollees who remain eligible for healthcare coverage through the program.
Currently, enrollment in the Health Benefits for Immigrant Seniors program will remain open.
However, HBIS will be temporarily paused for Fiscal Year 2024 if the number of people enrolled in the program reaches 16,500.
Anyone who is already enrolled in and remains eligible for coverage through the HBIA and HBIS programs will keep being covered.
The Department will not remove any current enrollees who remain eligible for this coverage, and hopes to resume new enrollments as soon as financially possible.
The enrollment changes are necessary to bring program costs within the budgeted amount for State Fiscal Year 2024, which starts July 1.
Compared with the Medicaid population, month-over-month enrollment has grown at a higher rate and per-enrollee costs have tracked higher among the HBIA and HBIS-enrolled populations due to untreated chronic conditions and higher hospital costs.
In addition to program enrollment modifications, HFS will apply other changes to limit program costs, including putting in place co-pays for HBIA and HBIS enrollees for hospital services when they are not eligible for a federal match:
- Inpatient hospitalization, $250 co-pay
- Hospital emergency room visits, $100 co-pay
- Hospital or Ambulatory Surgical Treatment Center outpatient services, 10% co-insurance
HFS plans to use the following to enhance revenue:
- Tracking methodology to maximize federal reimbursement for emergency medical expenses.
- Following supplemental prescription drug rebates for the covered noncitizen population.
- Transitioning HBIA and HBIS program enrollees to the Medicaid Managed Care program starting January 1, 2024, which will generate additional dollars to fund the programs through taxes the Department collects from the Medicaid Managed Care Organizations.
- Addressing current overpayments to the Cook County Hospital System.
