HEALTH CARE POLICY PLATFORM

HEALTH CARE POLICY PLATFORM

CONTENTS VISION 4 AFFORDABLE HEALTHCARE FOR ALL 5 On the Path to Single-Payer: A State-Backed Public Option 5 Keeping the Affordable Care Act Strong: A Statewide Health Insurance Mandate 5 Medicaid Buy-In Program 5 Mandated Transparency for Hikes in Drug Prices 6 Mandate Transparency for Hospital Profitability 6 INCREASING ACCESS TO HEALTHCARE 6 Create a Prescription Drug Buy-Back Program 6 Make Medical Care Available in Every Illinois County 7 Oppose a Medicaid Work Requirement 7 Extending Eyeglasses and Contact Prescription Expiration Periods 7 PROTECTING OUR WORKERS 8 Healthcare Workforce 8 Paid Family Leave 8 TREATING ADDICTION AND MENTAL HEALTH 9 Adopt a Hub and Spoke Program to Treat Addiction 9 Ensuring Continuity of Care and Access for the Reentry Population 9 Set Limits for Prescription Narcotics 10 Expand Number of Needle Exchange Sites and Coordinate Care 10 Gun Violence Transparency Requirements 10 Fund Primary Health Clinics and Integrate Mental Health Services 10 CARING FOR SENIORS AND PEOPLE WITH DISABILITIES 11 Building a Strong Network of Home and Community Based Services 11 Training a Pipeline of Direct Care Workers 11 Increase the Personal Needs Allowance 11 Increasing Nursing Home Staffing and Oversight 12 STANDING WITH WOMEN: WOMEN-SPECIFIC HEALTH CARE 12 Abortion Access for All 12 Broader Access to Birth Control 12 Standardize the State s Sex Education Curriculum to be Inclusive of Women s Needs 12 STANDING WITH THE LGBTQ+ COMMUNITY: LGBTQ+ SPECIFIC HEALTH CARE 13 Uphold Protections for the LGBTQ+ Community 13 Increase Access to Healthcare 13 Standardize the State s Sex Education Curriculum to Be Inclusive of LGBTQ+ Needs 13 Cultural Competency Training for Health Care Providers 14 3

VISION Access to quality, affordable health care is the most fundamental basis for quality of life. Chris Kennedy and Ra Joy believe that Illinois can play a major role in ensuring that every resident has access to health care and quality healthcare experiences at all stages of life. No individual or family should suffer for lack of access to care, and no individual or family should suffer because they cannot afford health care. Our state thrives when our residents are healthy and able to contribute fully to society. We envision a state where high-quality health care is easily accessible, affordable, and delivered with compassion. 4

AFFORDABLE HEALTHCARE FOR ALL ON THE PATH TO SINGLE-PAYER: A STATE-BACKED PUBLIC OPTION A Kennedy/Joy administration will put Illinois on a path to a single-payer system. We will start by creating a state-backed public option of large-scale, Illinois-based employers and pre-existing municipal insurance pools to allow them to aggregate together as one negotiating entity to drive down costs. This will reduce our reliance on costly, profit-driven insurance companies and provide modern, accessible, and just coverage to all. These aggregated insurance pools will emerge as an economic and political force in the state with clout, leverage, and contacts to overcome the insurance lobby. By allowing the largest employers in the state to work together to negotiate the cost of health coverage and drug prices, existing insurance companies will become nothing more than benefits managers. Once established, with a solid foundation of committed members and employers, the employer-backed option will be made available to anyone in the state including undocumented immigrants which will further drive down costs for plan holders and the overall healthcare market in Illinois. KEEPING THE AFFORDABLE CARE ACT STRONG: A STATEWIDE HEALTH INSURANCE MANDATE A Kennedy/Joy administration believes that everyone in our state should have health insurance. A rising tide lifts all boats: when we partner together, when everyone contributes, we can cover everyone s costs, and every member of our society is contributing to every other person s wellbeing. The new Republican Tax Plan has eliminated the Obamacare healthcare mandate, which is predicted to cause everyone s premiums to rise and leave more people without health insurance. States around the country are working to enact statewide healthcare mandates, and Illinois should be no exception. A Healthcare Mandate for Illinois will keep everyone insured and help control the rising cost of healthcare. MEDICAID BUY-IN PROGRAM Every person in our state should have access to affordable, quality health insurance. However, for a family of four in Illinois, the federal government will only subsidize the cost of monthly premiums if that family s net income is $98,400 or less. As premiums rise due to decisions by the republicans in Washington, but income levels stay the same, there will be a gap in coverage, a so-called donut of people, who do not qualify for Medicaid but whose premiums are too high to be affordable. A Kennedy/Joy administration will create a Medicaid Buy-In Program to allow those 5

families who cannot afford a plan on the Healthcare Exchange but who also don t qualify for Medicaid to pay a less expensive premium, based on their income, in order to receive Medicaid coverage. MANDATED TRANSPARENCY FOR HIKES IN DRUG PRICES Prescription drugs should be widely accessible to those who need them. Whether your medication clears up an infection, helps you manage pain, or literally saves your life, it should not be cost-prohibitive to obtain. A Kennedy/Joy administration believes it is the government s job to protect all consumers from the profit-seeking motives of big pharma. Right now, pharmaceutical companies can raise the price of any drug, even if there are multiple other virtually identical drugs on the market, and go unchecked. Consumers often don t know the price of their medication has gone up until they go to pay for it at their drug store. A Kennedy/Joy administration will follow the state of California s lead and mandate Drug Price Increase Notification Requirements. Drug companies will be required to issue a notification and justification if they plan to raise the price of a drug 60 days prior to the increase, and insurance companies will be required to report how increases in drug costs affect the cost of healthcare premiums and copays. This law will create transparency for consumers so they can speak to their doctors about alternatives, and the law will provide information to regulators so that they can more effectively intervene when rates are being raised without proper justification. MANDATE TRANSPARENCY FOR HOSPITAL PROFITABILITY Consumers deserve to know how much profit the hospitals in their neighborhoods, cities, and counties are earning. Illinois should mandate greater transparency around hospital profitability, especially for those hospitals with non-profit status, to ensure that they are living up to their mission to serve a diverse group of people. INCREASING ACCESS TO HEALTHCARE CREATE A PRESCRIPTION DRUG BUY-BACK PROGRAM Illinois can transform healthcare access for the uninsured and underinsured across our state through a prescription drug buy-back program. Not only are drug prices on the rise, but the state of Illinois, unlike 42 other states, has done nothing to reduce the amount of pharmaceutical waste that is generated by requirements that forbid medical facilities, like hospitals, nursing homes, and long-term care facilities, from recycling medication that has been prescribed to a patient who does not take the full course of treatment and donating that medication to those in need. 6 Medical facilities generate millions of dollars of unused drugs that are untampered with,

in sealed packages, and unexpired, but in Illinois they are required to dispose of these medications. A Kennedy/Joy administration would create a Prescription Drug Buy-Back Program where a state-backed non-profit would act as a repository, collecting, sorting, and controlling for quality drugs that are donated by licensed medical facilities. The non-profit repository then donates the unused medication back to pharmacies across the state who distribute them to uninsured and underinsured individuals. Not only does this increase equity by making medication available to people in the state who have the least access health care, but it reduces unnecessary waste that drives up the cost of healthcare for everyone. MAKE MEDICAL CARE AVAILABLE IN EVERY ILLINOIS COUNTY Many counties in Illinois don t have access to adequate medical care within their county, with access to specialists being especially dire in some counties. A Kennedy/ Joy administration will scale up hospital and clinic operations in every county in the state, starting with communities situated farthest from a general hospital or healthcare center. We will work with the federal government to expand the number of Federally Qualified Health Centers to counties with the most need, and we will expand the existing loan-forgiveness program than incentivizes doctors and nurses to practice in federally designated health professional shortage areas (HPSA). Illinois must be a nationwide leader in telemedicine, which is the new frontier of medical care. That s why a Kennedy/Joy administration will require insurance companies and Medicaid to cover telehealth services that will increase access to care across our state. Currently 26 other states require insurance companies to cover telehealth services, while Illinois has lagged behind. Telemedicine brings much-needed care to people wherever they are and serves to lower overall healthcare expenses by providing preventative care, which will save taxpayers money over the long term. Illinois should embrace telemedicine. OPPOSE A MEDICAID WORK REQUIREMENT A Kennedy/Joy administration will fiercely oppose the efforts of the Trump Administration to impose a work requirement for Medicaid eligibility. Requiring Medicaid recipients to prove that they are working is both morally wrong and could leave as many as 400,000 Illinoisans without healthcare. Healthcare is a right, not a privilege, and Medicaid is designed to provide healthcare to people who cannot afford other care, whatever their reasons are for not being able to afford other coverage. Governor Rauner is reportedly considering applying for a federal waiver to get permission to make employment a condition of receiving Medicaid. For a Kennedy/Joy administration, there would be nothing to consider. This policy is an automatic and emphatic no. EXTENDING EYEGLASSES AND CONTACT PRESCRIPTION EXPIRATION PERIODS In Illinois, prescriptions for glasses and contacts expire after one year, essentially forcing consumers to pay to see a doctor anytime they need new glasses or contacts. This is 7

especially onerous for low- and middle-income earners. A Kennedy/Joy administration will lengthen the expiration periods of these prescriptions. PROTECTING OUR WORKERS HEALTHCARE WORKFORCE We will pass a $15 minimum wage bill that will be a required base minimum pay for all caregivers and healthcare workers. License-exempt caregivers who are caring for our children often the children of low-income families should not be earning less than minimum wage. Some license-exempt providers are earning as little as $16.22 per day. This is unacceptable. No one who works a full-time job should be forced to live in poverty. A Kennedy/Joy administration will ensure that healthcare providers and caregivers are never paid below a $15 minimum wage. A Kennedy/Joy administration will fight attacks against home healthcare workers, like those that have come from the current administration. These attacks, like the plan to cap income eligibility levels for seniors and people with disabilities to receive care, or the scheme to limit the number of overtime hours home healthcare workers can work are wrong. Both measures would destabilize care for these populations and cause home healthcare workers financial hardship. PAID FAMILY LEAVE A Kennedy/Joy administration will institute 12 weeks of paid family leave, following the model New York has recently adopted, where annual employee payroll contributions are capped at $85.56 per year to fund the program. Employees will receive a percentage of their weekly wage for 12 weeks, with their total weekly payments capped at a percentage of the Statewide Average Weekly Wage in Illinois. This will ensure that employees have job protection, health insurance, and financial support when they need to take time off from work for personal reasons. Whether you re a mother who has just given birth, a new father who wants to spend time with his family, caring for a loved one, or suffering from an illness yourself, Illinoisans should not incur an economic burden for needing to attend to circumstances in their personal lives. Additionally, paid leave must include adoption and foster children entering the home as qualifying reasons to take paid leave. There are only eight countries in the entire world that do not offer paid maternity leave. Not only is the US one of those eight countries, but we are the only high-income country that doesn t offer leave, according to the World Bank. 8 Illinois cannot afford to wait for the federal government to institute nationwide paid family leave. Offering paid leave is an issue of fairness as much as it is a good business practice. If Illinois is to be an attractive state for the next generation to build their careers

here, we cannot afford to deny workers rights they can get in other states. In states like California that have had paid family leave in effect for over a decade, not only did the vast majority of large and small businesses alike report no noticeable effect on the profitability and performance of their businesses, but employers also report improved morale and productivity. TREATING ADDICTION AND MENTAL HEALTH ADOPT A HUB AND SPOKE PROGRAM TO TREAT ADDICTION Addiction is a disease, but unlike many diseases, addiction does not have a singular cure. It is only through a comprehensive approach to addiction treatment that people with substance-use disorder can gain enough tools and support to maintain sobriety. A Kennedy/Joy administration is committed to providing that support to communities throughout Illinois. The opioid crisis is claiming lives across our state: in big cities like Chicago, which have long suffered from government indifference to issues of addiction particularly in predominantly minority communities and in rural areas, where addiction to opioids has exploded in recent years. A Kennedy/Joy administration will follow Vermont s innovative lead by adopting a Hub and Spoke model to treat addiction. A Hub and Spoke program is a comprehensive addiction treatment plan where patients first interact with the hub, or nexus where they receive intensive treatment from teams of nurses, counselors, and prescribing MDs. At the hub clinic patients receive a medical assessment, care coordination, therapy, and medication-assisted treatment using antiwithdrawal medications like methadone and buprenorphine. Patients must come to the hub daily in order to receive their anti-withdrawal medication. Over time as patients become more stable, they are transitioned to the different spokes for specialized treatment that varies from patient to patient. The spokes include: mental health services, pain management clinics, family services, residential services, inpatient and outpatient addiction programs, medical homes, and support services to help manage outstanding legal issues like probation or parole. ENSURING CONTINUITY OF CARE AND ACCESS FOR THE REENTRY POPULATION Achieving and maintaining healthy and productive lifestyles increases former inmates chances of finding work, successfully reintegrating into their communities, and staying out of prison. This is particularly true for inmates who have mental health or substance-use disorders. Without healthcare coverage, many of them are released without the ability to get the medications they need. Before they are released from prison, inmates should be confirmed 9

participants in Medicaid. This means that prisons must make an effort to sign inmates up early enough to have the inmate s enrollment ready on the day of his or her release. In addition, the state would ensure that inmates released from prison work directly with a care coordinator whose responsibility is to help them find a primary care doctor, make and confirm appointments, and learn about urgent care, health care specialists, and transportation benefits. A Kennedy/Joy administration would work to seamlessly coordinate between the Department of Corrections and the State Medicaid program. SET LIMITS FOR PRESCRIPTION NARCOTICS Everyone should be able to access pain management medication when it is needed. However, we must recognize that prescription narcotics are highly addictive, and the existing incentives lead physicians to over-prescribe the number of pills in a prescription. We must fix the current reimbursement system so that doctors are rewarded for interacting with patients late at night and on the weekends to determine if there is a medical condition that requires additional narcotics. This will also decrease the possibility of leftover narcotics ending up on the black market and fueling addiction. Illinois should also prevent pharmacy shopping by creating a state tracking system that notifies pharmacies if patients are trying to fill prescriptions for narcotics at multiple pharmacies during a short timeframe. EXPAND NUMBER OF NEEDLE EXCHANGE SITES AND COORDINATE CARE Needle exchange programs prevent the spread of HIV, hepatitis, and other blood-borne diseases. They also provide an entry point for addiction treatment and other health services, like testing for STIs and HIV. There are nine needle exchange sites currently operating in Illinois: three in Chicago, two in Springfield, with others in Belleville, Champaign, Dixon, and Kankakee. A Kennedy/Joy administration would expand the number of needle exchange sites so that epicenters of addiction, whether they be in rural or urban parts of the state, have access to this simple, low-cost, and effective measure to provide care and prevent the spread of diseases. GUN VIOLENCE TRANSPARENCY REQUIREMENTS Gun violence has a ripple effect through entire communities. The bullet that kills the father wounds the child, and the trauma suffered by all those who are impacted by violence is pervasive and life-changing. A Kennedy/Joy administration will require hospitals to report the number of gun-violence victims who are treated at their facilities. This information will allow the state to gather data on gun violence to a) better target mental health and trauma care to the communities that need it most and b) make the data transparent to the public, which many cities and police departments fail to do. The disclosure of personal information will be exempt, so as not to violate HIPAA. 10 FUND PRIMARY HEALTH CLINICS AND INTEGRATE MENTAL HEALTH SERVICES The current administration s manufactured budget crisis was devastating for our state s mental healthcare providers. Lutheran Social Services, the state s largest provider of social

services, was forced to close more than 30 programs around the state when they stopped receiving funding from the state due to the lack of a state budget. Even with the budget that the state now has, the majority of shuttered programs remain closed, cutting off entire communities from care. A Kennedy/Joy administration will work with providers to reopen and expand primary health clinics and to integrate mental health services in these clinics across the state. CARING FOR SENIORS AND PEOPLE WITH DISABILITIES BUILDING A STRONG NETWORK OF HOME AND COMMUNITY BASED SERVICES Seniors and people with disabilities deserve universal long-term care. A Kennedy/Joy administration will fight the republican effort to make Medicaid into a block grant program or a per capita program that would threaten Home and Community Based Services (HCBS) and Long-Term Support Services (LTSS). We will work to expand the social safety-net and commit to a budget that funds crucial programs like the Community Cares Programs, which ensures that seniors have access to home health care that allows them to maintain their independence and avoid high-cost nursing home facilities. TRAINING A PIPELINE OF DIRECT CARE WORKERS Maintaining a pipeline of qualified, well-trained, and fairly compensated direct-care workers is a long-term challenge we need to address as a state through a robust workforce development program. There is a significantly larger role that our state could play in increasing access to higher education and job training for in-demand fields, like health care and direct care. A Kennedy/Joy administration will adopt a college Promise Program in Illinois, modeled after states like Tennessee, Oregon, or Minnesota, where two years of free community college or workforce training help feed in-state apprenticeships and employment pipelines to these critically important careers. INCREASE THE PERSONAL NEEDS ALLOWANCE People with developmental disabilities receive a Medicaid per diem called a Personal Needs Allowance. This money is intended to pay for small-dollar items that Medicaid does not cover, like snacks, clothes, and haircuts. Currently, people living in intermediate care facilities only receive $30 a month. That is only a dollar per day. This is shameful. A Kennedy/Joy administration will increase the Personal Needs Allowance to $80 per month, which will give individuals with developmental disabilities more economic agency. Increasing the Personal Needs Allowance is also a good for the economy, since the additional money for the allowance will be spent right away, often in communities and at small businesses. INCREASING NURSING HOME STAFFING AND OVERSIGHT Governor Rauner centralized nursing home oversight boards and eliminated the regional governance structure that was better able to hold nursing homes accountable to the highest standards. A Kennedy/Joy administration would restore regional oversight to our state s nursing homes. 11

In order to offer quality care, Illinois must also increase the number of mandated direct-care hours per resident per day in order to meet federal standards. Currently, Illinois mandates a minimum of 3.8 hours per resident per day while federal standards recommended that each resident receive 4.1 hours. A Kennedy/Joy administration will work to make sure that all nursing home residents receive the care they deserve. In order to maintain quality and consistency of care, the state must pay nursing homes in a timely manner. A Kennedy/Joy administration will direct the State Comptroller to create a revolving loan fund so that the state pays nursing homes what it owes them immediately. STANDING WITH WOMEN: WOMEN-SPECIFIC HEALTH CARE ABORTION ACCESS FOR ALL A Kennedy/Joy administration will uphold a woman s right to choose. We will protect and ensure the implementation of the provisions in HB 40, which directs Medicaid to cover the cost of abortions for low-income women. Abortion should not be a luxury for the rich but a true choice for every woman regardless of financial circumstance. That s why our administration will be focused on increasing access to abortion across the state, where only 61% of women live in a county with an abortion provider. We will fully fund Planned Parenthood, and our administration will set a goal of scaling up providers so that there is at least one abortion provider in every county throughout Illinois. BROADER ACCESS TO BIRTH CONTROL A Kennedy/Joy administration will work to legalize the sale of over-the-counter (OTC) birth control pills because access to birth control is like access to abortion: it s a fundamental part of women s reproductive rights. This past February, Colorado became the third state in the country to allow OTC birth control, after California and Oregon. We believe Illinois should follow the lead of these states with the assisted guidance of medical professionals. Under our administration, we will set a goal for Illinois to have the lowest level of unplanned pregnancies of any state in the nation. STANDARDIZE THE STATE S SEX EDUCATION CURRICULUM TO BE INCLUSIVE OF WOMEN S NEEDS A Kennedy/Joy administration believes that knowledge brings power, and we need to ensure that all students are receiving science-based, medically accurate, and age-appropriate information in their sex education classes. This includes information about birth control, Plan B, abortion, sexual harassment, domestic violence, rape, and tools for survivors. 12

STANDING WITH THE LGBTQ+ COMMUNITY: LGBTQ+ SPECIFIC HEALTH CARE UPHOLD PROTECTIONS FOR THE LGBTQ+ COMMUNITY A Kennedy/Joy administration will fight to protect the Affordable Care Act (ACA) and uphold the anti-discrimination provisions in the ACA that prevent someone from being denied or given lesser healthcare coverage due to sexual orientation or gender identity. INCREASE ACCESS TO HEALTHCARE There are life-saving, transformative drugs on the market that everyone in the LGBTQ+ community should be able to access, regardless of socioeconomic status. These include access to hormone replacement therapy and PrEP, throughout the state as well as inside our jails and prisons. There is only one clinic outside of Chicago where a transgender person can receive hormone replacement therapy. That means that people across our state have to travel great distances for this medically necessary treatment or go without. A Kennedy/Joy administration is committed to increasing the number of hormone replacement therapy providers throughout Illinois. We will follow the example of Florida by working to provide PrEP at no cost for our high-risk and/or low-income population in every county in Illinois. A Kennedy/Joy administration will also fund LGBTQ+-specific mental health and counseling services at community health clinics and in grade schools, as well as in our public university system. STANDARDIZE THE STATE S SEX EDUCATION CURRICULUM TO BE INCLUSIVE OF LGBTQ+ NEEDS A Kennedy/Joy administration will push for Illinois to require our public schools to teach sex education with a curriculum that is science-based, medically accurate, age-appropriate, and inclusive. Sex education is key to ensuring every student gets medically accurate information on safe sex practices. It is critical that Illinois update our sex education curriculum around the state to include mandated lessons on HIV testing and treatment that focus on de-stigmatizing an HIV-positive diagnosis. The curriculum should further emphasize the importance of taking precautions like PrEP and educating everyone about the positive, lifesaving effects of antiretroviral medication. CULTURAL COMPETENCY TRAINING FOR HEALTH CARE PROVIDERS No one should be victimized or made to feel unsafe when they interact with medical professionals. A Kennedy/Joy administration will institute cultural competency training as a part of receiving a license to practice medicine or become a nurse in Illinois. While some hospitals in Illinois already offer this training, it should be mandatory. We will also work with hospitals and medical professionals to ensure that there is a reporting system for LGBTQ+ people to lodge complaints and make it known when care is not culturally competent. 13

14 WWW.KENNEDYFORILLINOIS.COM