Coalition letter to the Illinois Department of Public Aid expressing concerns about proposed rules for the Health Benefits for Workers with Disabilities program

October 5, 2001

Joanne Jones
Office of the General Counsel, Rules Section
Illinois Department of Public Aid
201 S. Grand Ave. East, third floor
Springfield, Illinois 62763

Dear Ms. Jones:

I am writing to express some concerns related to IDPA's proposed rules for the Health Benefits for Workers with Disabilities (HBWD) program. These concerns are shared by the AIDS Foundation of Chicago and several members of our Policy/Advocacy Committee. A complete list of organizations endorsing this letter is attached.

As Illinois' leading advocate for people living with and at risk for HIV/AIDS, the AIDS Foundation of Chicago is committed to ensuring that the HBWD program is widely accessible to individuals with disabilities living in Illinois. As you may know, extensive availability of triple-combination drug therapy has resulted in dramatic improvements in the lives and health of many Illinoisans living with AIDS. These drugs have meant the difference between life and death for thousands of people across the state, many of whom are planning to reenter the workforce after time spent dependent on SSDI. Broad access to the HBWD program is critical to creating a secure environment in which these individuals can return to work without the fear of losing their access to the health care system.

Our concerns with the proposed rule change are three fold:

1. The proposed income eligibility cap of 200% of the federal poverty level is too low. Most states that allow for Medicaid buy-in start eligibility at 250% FPL or higher allowing for greater access to the program. At 200% of poverty, an individual can earn no more than $1,432/month which is not sufficient for self-support. IDPA's proposed cap is particularly unfair as the Department plans to use both earned and unearned income to determine an applicant's eligibility, creating a situation in which an individual's status as disabled actually works against them. Additionally, through the 1619(b) program, single individuals can currently earn up to $23,000 without losing their Medicaid. These rules would dramatically decrease their allowed earnings leaving many without health insurance coverage. We urge you to raise the program eligibility to at least 250% of the federal poverty level.
   
   
2. Including spousal income in determining program eligibility would effectively disqualify married individuals from participating in the program. This provision discriminates against married individuals and judges an individual's eligibility on more than their own income and earning potential, effectively barring them from receiving benefits. We urge you to consider only the applicant's earnings when determining program eligibility.
   
   
3. The proposed asset limit of $10,000 unfairly includes retirement accounts. This provision punishes individuals with disabilities for planning for their long-term care and self-sufficiency and creates a disincentive for them to seek employment that includes a pension, 401K or other retirement benefits. We urge you not to include retirement accounts when determining program eligibility.

As you move ahead in crafting fair and equitable rules to govern the HBWD program, I urge you to consider our concerns and to work with community-based service and advocacy agencies so that Illinoisans have adequate and appropriate access to this vital program.

Please feel free to contact me if you need additional information or have questions about our comments. I can be reached at 312-922-2322.

Sincerely,
Karen A. Reitan
Manager of State Affairs

Organizations endorsing this letter:

AIDS Foundation of Chicago - 411 S. Wells, Chicago Illinois 60607 Contact - Karen Reitan, Manager of State Affairs, 312-922-2322

AIDS Legal Council of Chicago - 188 W. Randolph, Chicago Illinois 60601 Contact - Ann Hilton Fisher, Executive Director, 312-427-8990

Equip for Equality - 11 E. Adams, Chicago Illinois 60603 Contact - Murray Manus, Legislative Policy Manager, 312-341-0022

International Association of Physicians in AIDS Care - 33 N. LaSalle, Chicago Illinois 60602 Contact - Jose Zuniga, President and CEO, 312-795-4930

Lambda Legal Defense and Education Fund - 11 E. Adams, Chicago Illinois 60603 Contact - Heather Sawyer, Legal Counsel, 312-663-4413

Roger Baldwin Foundation/ACLU - 180 N. Michigan, Chicago Illinois 60601 Contact - Pamela Sumners, Project Director, 312-201-9740