MEDICAID-PERSON W/DISABILITIES

Illinois General Assembly - Full Text of HB1568

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB1568

Introduced 1/28/2025, by Rep. Hoan Huynh

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-2

from Ch. 23, par. 5-2

Amends the Medical Assistance Article of the Illinois Public Aid
Code. In provisions concerning medical assistance for employed persons
with disabilities and employed persons with a medically improved
disability, provides that, subject to federal approval, the Department of
Healthcare and Family Services shall eliminate income eligibility
standards for such persons to the extent permitted by federal law and shall
eliminate the consideration of assets when determining such persons
eligibility for medical assistance to the extent permitted by federal law.
LRB104 06181 KTG 16215 b

A BILL FOR

HB1568
LRB104 06181 KTG 16215 b
1

AN ACT concerning public aid.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Illinois Public Aid Code is amended by
5
changing Section 5-2 as follows:

6

(305 ILCS 5/5-2)

(from Ch. 23, par. 5-2)
7

Sec. 5-2.
Classes of persons eligible.
Medical assistance
8
under this Article shall be available to any of the following
9
classes of persons in respect to whom a plan for coverage has
10
been submitted to the Governor by the Illinois Department and
11
approved by him. If changes made in this Section 5-2 require
12
federal approval, they shall not take effect until such
13
approval has been received:
14

1. Recipients of basic maintenance grants under
15

Articles III and IV.
16

2. Beginning January 1, 2014, persons otherwise
17

eligible for basic maintenance under Article III,
18

excluding any eligibility requirements that are
19

inconsistent with any federal law or federal regulation,
20

as interpreted by the U.S. Department of Health and Human
21

Services, but who fail to qualify thereunder on the basis
22

of need, and who have insufficient income and resources to
23

meet the costs of necessary medical care, including, but

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not limited to, the following:
2

(a) All persons otherwise eligible for basic
3

maintenance under Article III but who fail to qualify
4

under that Article on the basis of need and who meet
5

either of the following requirements:
6

(i) their income, as determined by the
7

Illinois Department in accordance with any federal
8

requirements, is equal to or less than 100% of the
9

federal poverty level; or
10

(ii) their income, after the deduction of
11

costs incurred for medical care and for other
12

types of remedial care, is equal to or less than
13

100% of the federal poverty level.
14

(b) (Blank).
15

3. (Blank).
16

4. Persons not eligible under any of the preceding
17

paragraphs who fall sick, are injured, or die, not having
18

sufficient money, property or other resources to meet the
19

costs of necessary medical care or funeral and burial
20

expenses.
21

5.(a) Beginning January 1, 2020, individuals during
22

pregnancy and during the 12-month period beginning on the
23

last day of the pregnancy, together with their infants,
24

whose income is at or below 200% of the federal poverty
25

level. Until September 30, 2019, or sooner if the
26

maintenance of effort requirements under the Patient

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1

Protection and Affordable Care Act are eliminated or may
2

be waived before then, individuals during pregnancy and
3

during the 12-month period beginning on the last day of
4

the pregnancy, whose countable monthly income, after the
5

deduction of costs incurred for medical care and for other
6

types of remedial care as specified in administrative
7

rule, is equal to or less than the Medical Assistance-No
8

Grant(C) (MANG(C)) Income Standard in effect on April 1,
9

2013 as set forth in administrative rule.
10

(b) The plan for coverage shall provide ambulatory
11

prenatal care to pregnant individuals during a presumptive
12

eligibility period and establish an income eligibility
13

standard that is equal to 200% of the federal poverty
14

level, provided that costs incurred for medical care are
15

not taken into account in determining such income
16

eligibility.
17

(c) The Illinois Department may conduct a
18

demonstration in at least one county that will provide
19

medical assistance to pregnant individuals together with
20

their infants and children up to one year of age, where the
21

income eligibility standard is set up to 185% of the
22

nonfarm income official poverty line, as defined by the
23

federal Office of Management and Budget. The Illinois
24

Department shall seek and obtain necessary authorization
25

provided under federal law to implement such a
26

demonstration. Such demonstration may establish resource

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standards that are not more restrictive than those
2

established under Article IV of this Code.
3

6. (a) Subject to federal approval, children younger
4

than age 19 when countable income is at or below 313% of
5

the federal poverty level, as determined by the Department
6

and in accordance with all applicable federal
7

requirements. The Department is authorized to adopt
8

emergency rules to implement the changes made to this
9

paragraph by Public Act 102-43. Until September 30, 2019,
10

or sooner if the maintenance of effort requirements under
11

the Patient Protection and Affordable Care Act are
12

eliminated or may be waived before then, children younger
13

than age 19 whose countable monthly income, after the
14

deduction of costs incurred for medical care and for other
15

types of remedial care as specified in administrative
16

rule, is equal to or less than the Medical Assistance-No
17

Grant(C) (MANG(C)) Income Standard in effect on April 1,
18

2013 as set forth in administrative rule.
19

(b) Children and youth who are under temporary custody
20

or guardianship of the Department of Children and Family
21

Services or who receive financial assistance in support of
22

an adoption or guardianship placement from the Department
23

of Children and Family Services.
24

7. (Blank).
25

8. As required under federal law, persons who are
26

eligible for Transitional Medical Assistance as a result

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of an increase in earnings or child or spousal support
2

received. The plan for coverage for this class of persons
3

shall:
4

(a) extend the medical assistance coverage to the
5

extent required by federal law; and
6

(b) offer persons who have initially received 6
7

months of the coverage provided in paragraph (a)
8

above, the option of receiving an additional 6 months
9

of coverage, subject to the following:
10

(i) such coverage shall be pursuant to
11

provisions of the federal Social Security Act;
12

(ii) such coverage shall include all services
13

covered under Illinois' State Medicaid Plan;
14

(iii) no premium shall be charged for such
15

coverage; and
16

(iv) such coverage shall be suspended in the
17

event of a person's failure without good cause to
18

file in a timely fashion reports required for this
19

coverage under the Social Security Act and
20

coverage shall be reinstated upon the filing of
21

such reports if the person remains otherwise
22

eligible.
23

9. Persons with acquired immunodeficiency syndrome
24

(AIDS) or with AIDS-related conditions with respect to
25

whom there has been a determination that but for home or
26

community-based services such individuals would require

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the level of care provided in an inpatient hospital,
2

skilled nursing facility or intermediate care facility the
3

cost of which is reimbursed under this Article. Assistance
4

shall be provided to such persons to the maximum extent
5

permitted under Title XIX of the Federal Social Security
6

Act.
7

10. Participants in the long-term care insurance
8

partnership program established under the Illinois
9

Long-Term Care Partnership Program Act who meet the
10

qualifications for protection of resources described in
11

Section 15 of that Act.
12

11. Persons with disabilities who are employed and
13

eligible for Medicaid, pursuant to Section
14

1902(a)(10)(A)(ii)(xv) of the Social Security Act, and,
15

subject to federal approval, persons with a medically
16

improved disability who are employed and eligible for
17

Medicaid pursuant to Section 1902(a)(10)(A)(ii)(xvi) of
18

the Social Security Act, as provided by the Illinois
19

Department by rule. In establishing eligibility standards
20

under this paragraph 11, the Department shall, subject to
21

federal approval:
22

(a)
eliminate income eligibility standards to the
23

extent permitted by federal law

set the income
24

eligibility standard at not lower than 350% of the
25

federal poverty level
;
26

(b) exempt retirement accounts that the person

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cannot access without penalty before the age of 59
2

1/2, and medical savings accounts established pursuant
3

to 26 U.S.C. 220;
and

4

(c)
eliminate the consideration of assets when
5

determining eligibility under this paragraph to the
6

extend permitted by federal law

allow non-exempt
7

assets up to $25,000 as to those assets accumulated
8

during periods of eligibility under this paragraph 11
;
9

and
10

(d) continue to apply subparagraphs (b) and (c) in
11

determining the eligibility of the person under this
12

Article even if the person loses eligibility under
13

this paragraph 11.
14

12. Subject to federal approval, persons who are
15

eligible for medical assistance coverage under applicable
16

provisions of the federal Social Security Act and the
17

federal Breast and Cervical Cancer Prevention and
18

Treatment Act of 2000. Those eligible persons are defined
19

to include, but not be limited to, the following persons:
20

(1) persons who have been screened for breast or
21

cervical cancer under the U.S. Centers for Disease
22

Control and Prevention Breast and Cervical Cancer
23

Program established under Title XV of the federal
24

Public Health Service Act in accordance with the
25

requirements of Section 1504 of that Act as
26

administered by the Illinois Department of Public

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Health; and
2

(2) persons whose screenings under the above
3

program were funded in whole or in part by funds
4

appropriated to the Illinois Department of Public
5

Health for breast or cervical cancer screening.
6

"Medical assistance" under this paragraph 12 shall be
7

identical to the benefits provided under the State's
8

approved plan under Title XIX of the Social Security Act.
9

The Department must request federal approval of the
10

coverage under this paragraph 12 within 30 days after July
11

3, 2001 (the effective date of Public Act 92-47).
12

In addition to the persons who are eligible for
13

medical assistance pursuant to subparagraphs (1) and (2)
14

of this paragraph 12, and to be paid from funds
15

appropriated to the Department for its medical programs,
16

any uninsured person as defined by the Department in rules
17

residing in Illinois who is younger than 65 years of age,
18

who has been screened for breast and cervical cancer in
19

accordance with standards and procedures adopted by the
20

Department of Public Health for screening, and who is
21

referred to the Department by the Department of Public
22

Health as being in need of treatment for breast or
23

cervical cancer is eligible for medical assistance
24

benefits that are consistent with the benefits provided to
25

those persons described in subparagraphs (1) and (2).
26

Medical assistance coverage for the persons who are

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eligible under the preceding sentence is not dependent on
2

federal approval, but federal moneys may be used to pay
3

for services provided under that coverage upon federal
4

approval.
5

13. Subject to appropriation and to federal approval,
6

persons living with HIV/AIDS who are not otherwise
7

eligible under this Article and who qualify for services
8

covered under Section 5-5.04 as provided by the Illinois
9

Department by rule.
10

14. Subject to the availability of funds for this
11

purpose, the Department may provide coverage under this
12

Article to persons who reside in Illinois who are not
13

eligible under any of the preceding paragraphs and who
14

meet the income guidelines of paragraph 2(a) of this
15

Section and (i) have an application for asylum pending
16

before the federal Department of Homeland Security or on
17

appeal before a court of competent jurisdiction and are
18

represented either by counsel or by an advocate accredited
19

by the federal Department of Homeland Security and
20

employed by a not-for-profit organization in regard to
21

that application or appeal, or (ii) are receiving services
22

through a federally funded torture treatment center.
23

Medical coverage under this paragraph 14 may be provided
24

for up to 24 continuous months from the initial
25

eligibility date so long as an individual continues to
26

satisfy the criteria of this paragraph 14. If an

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individual has an appeal pending regarding an application
2

for asylum before the Department of Homeland Security,
3

eligibility under this paragraph 14 may be extended until
4

a final decision is rendered on the appeal. The Department
5

may adopt rules governing the implementation of this
6

paragraph 14.
7

15. Family Care Eligibility.
8

(a) On and after July 1, 2012, a parent or other
9

caretaker relative who is 19 years of age or older when
10

countable income is at or below 133% of the federal
11

poverty level. A person may not spend down to become
12

eligible under this paragraph 15.
13

(b) Eligibility shall be reviewed annually.
14

(c) (Blank).
15

(d) (Blank).
16

(e) (Blank).
17

(f) (Blank).
18

(g) (Blank).
19

(h) (Blank).
20

(i) Following termination of an individual's
21

coverage under this paragraph 15, the individual must
22

be determined eligible before the person can be
23

re-enrolled.
24

16. Subject to appropriation, uninsured persons who
25

are not otherwise eligible under this Section who have
26

been certified and referred by the Department of Public

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LRB104 06181 KTG 16215 b
1

Health as having been screened and found to need
2

diagnostic evaluation or treatment, or both diagnostic
3

evaluation and treatment, for prostate or testicular
4

cancer. For the purposes of this paragraph 16, uninsured
5

persons are those who do not have creditable coverage, as
6

defined under the Health Insurance Portability and
7

Accountability Act, or have otherwise exhausted any
8

insurance benefits they may have had, for prostate or
9

testicular cancer diagnostic evaluation or treatment, or
10

both diagnostic evaluation and treatment. To be eligible,
11

a person must furnish a Social Security number. A person's
12

assets are exempt from consideration in determining
13

eligibility under this paragraph 16. Such persons shall be
14

eligible for medical assistance under this paragraph 16
15

for so long as they need treatment for the cancer. A person
16

shall be considered to need treatment if, in the opinion
17

of the person's treating physician, the person requires
18

therapy directed toward cure or palliation of prostate or
19

testicular cancer, including recurrent metastatic cancer
20

that is a known or presumed complication of prostate or
21

testicular cancer and complications resulting from the
22

treatment modalities themselves. Persons who require only
23

routine monitoring services are not considered to need
24

treatment. "Medical assistance" under this paragraph 16
25

shall be identical to the benefits provided under the
26

State's approved plan under Title XIX of the Social

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1

Security Act. Notwithstanding any other provision of law,
2

the Department (i) does not have a claim against the
3

estate of a deceased recipient of services under this
4

paragraph 16 and (ii) does not have a lien against any
5

homestead property or other legal or equitable real
6

property interest owned by a recipient of services under
7

this paragraph 16.
8

17. Persons who, pursuant to a waiver approved by the
9

Secretary of the U.S. Department of Health and Human
10

Services, are eligible for medical assistance under Title
11

XIX or XXI of the federal Social Security Act.
12

Notwithstanding any other provision of this Code and
13

consistent with the terms of the approved waiver, the
14

Illinois Department, may by rule:
15

(a) Limit the geographic areas in which the waiver
16

program operates.
17

(b) Determine the scope, quantity, duration, and
18

quality, and the rate and method of reimbursement, of
19

the medical services to be provided, which may differ
20

from those for other classes of persons eligible for
21

assistance under this Article.
22

(c) Restrict the persons' freedom in choice of
23

providers.
24

18. Beginning January 1, 2014, persons aged 19 or
25

older, but younger than 65, who are not otherwise eligible
26

for medical assistance under this Section 5-2, who qualify

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1

for medical assistance pursuant to 42 U.S.C.
2

1396a(a)(10)(A)(i)(VIII) and applicable federal
3

regulations, and who have income at or below 133% of the
4

federal poverty level plus 5% for the applicable family
5

size as determined pursuant to 42 U.S.C. 1396a(e)(14) and
6

applicable federal regulations. Persons eligible for
7

medical assistance under this paragraph 18 shall receive
8

coverage for the Health Benefits Service Package as that
9

term is defined in subsection (m) of Section 5-1.1 of this
10

Code. If Illinois' federal medical assistance percentage
11

(FMAP) is reduced below 90% for persons eligible for
12

medical assistance under this paragraph 18, eligibility
13

under this paragraph 18 shall cease no later than the end
14

of the third month following the month in which the
15

reduction in FMAP takes effect.
16

19. Beginning January 1, 2014, as required under 42
17

U.S.C. 1396a(a)(10)(A)(i)(IX), persons older than age 18
18

and younger than age 26 who are not otherwise eligible for
19

medical assistance under paragraphs (1) through (17) of
20

this Section who (i) were in foster care under the
21

responsibility of the State on the date of attaining age
22

18 or on the date of attaining age 21 when a court has
23

continued wardship for good cause as provided in Section
24

2-31 of the Juvenile Court Act of 1987 and (ii) received
25

medical assistance under the Illinois Title XIX State Plan
26

or waiver of such plan while in foster care.

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20. Beginning January 1, 2018, persons who are
2

foreign-born victims of human trafficking, torture, or
3

other serious crimes as defined in Section 2-19 of this
4

Code and their derivative family members if such persons:
5

(i) reside in Illinois; (ii) are not eligible under any of
6

the preceding paragraphs; (iii) meet the income guidelines
7

of subparagraph (a) of paragraph 2; and (iv) meet the
8

nonfinancial eligibility requirements of Sections 16-2,
9

16-3, and 16-5 of this Code. The Department may extend
10

medical assistance for persons who are foreign-born
11

victims of human trafficking, torture, or other serious
12

crimes whose medical assistance would be terminated
13

pursuant to subsection (b) of Section 16-5 if the
14

Department determines that the person, during the year of
15

initial eligibility (1) experienced a health crisis, (2)
16

has been unable, after reasonable attempts, to obtain
17

necessary information from a third party, or (3) has other
18

extenuating circumstances that prevented the person from
19

completing his or her application for status. The
20

Department may adopt any rules necessary to implement the
21

provisions of this paragraph.
22

21. Persons who are not otherwise eligible for medical
23

assistance under this Section who may qualify for medical
24

assistance pursuant to 42 U.S.C.
25

1396a(a)(10)(A)(ii)(XXIII) and 42 U.S.C. 1396(ss) for the
26

duration of any federal or State declared emergency due to

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1

COVID-19. Medical assistance to persons eligible for
2

medical assistance solely pursuant to this paragraph 21
3

shall be limited to any in vitro diagnostic product (and
4

the administration of such product) described in 42 U.S.C.
5

1396d(a)(3)(B) on or after March 18, 2020, any visit
6

described in 42 U.S.C. 1396o(a)(2)(G), or any other
7

medical assistance that may be federally authorized for
8

this class of persons. The Department may also cover
9

treatment of COVID-19 for this class of persons, or any
10

similar category of uninsured individuals, to the extent
11

authorized under a federally approved 1115 Waiver or other
12

federal authority. Notwithstanding the provisions of
13

Section 1-11 of this Code, due to the nature of the
14

COVID-19 public health emergency, the Department may cover
15

and provide the medical assistance described in this
16

paragraph 21 to noncitizens who would otherwise meet the
17

eligibility requirements for the class of persons
18

described in this paragraph 21 for the duration of the
19

State emergency period.
20

In implementing the provisions of Public Act 96-20, the
21
Department is authorized to adopt only those rules necessary,
22
including emergency rules. Nothing in Public Act 96-20 permits
23
the Department to adopt rules or issue a decision that expands
24
eligibility for the FamilyCare Program to a person whose
25
income exceeds 185% of the Federal Poverty Level as determined
26
from time to time by the U.S. Department of Health and Human

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1
Services, unless the Department is provided with express
2
statutory authority.
3

The eligibility of any such person for medical assistance
4
under this Article is not affected by the payment of any grant
5
under the Senior Citizens and Persons with Disabilities
6
Property Tax Relief Act or any distributions or items of
7
income described under subparagraph (X) of paragraph (2) of
8
subsection (a) of Section 203 of the Illinois Income Tax Act.
9

The Department shall by rule establish the amounts of
10
assets to be disregarded in determining eligibility for
11
medical assistance, which shall at a minimum equal the amounts
12
to be disregarded under the Federal Supplemental Security
13
Income Program. The amount of assets of a single person to be
14
disregarded shall not be less than $2,000, and the amount of
15
assets of a married couple to be disregarded shall not be less
16
than $3,000.
17

To the extent permitted under federal law, any person
18
found guilty of a second violation of Article VIIIA shall be
19
ineligible for medical assistance under this Article, as
20
provided in Section 8A-8.
21

The eligibility of any person for medical assistance under
22
this Article shall not be affected by the receipt by the person
23
of donations or benefits from fundraisers held for the person
24
in cases of serious illness, as long as neither the person nor
25
members of the person's family have actual control over the
26
donations or benefits or the disbursement of the donations or

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1
benefits.
2

Notwithstanding any other provision of this Code, if the
3
United States Supreme Court holds Title II, Subtitle A,
4
Section 2001(a) of Public Law 111-148 to be unconstitutional,
5
or if a holding of Public Law 111-148 makes Medicaid
6
eligibility allowed under Section 2001(a) inoperable, the
7
State or a unit of local government shall be prohibited from
8
enrolling individuals in the Medical Assistance Program as the
9
result of federal approval of a State Medicaid waiver on or
10
after June 14, 2012 (the effective date of Public Act 97-687),
11
and any individuals enrolled in the Medical Assistance Program
12
pursuant to eligibility permitted as a result of such a State
13
Medicaid waiver shall become immediately ineligible.
14

Notwithstanding any other provision of this Code, if an
15
Act of Congress that becomes a Public Law eliminates Section
16
2001(a) of Public Law 111-148, the State or a unit of local
17
government shall be prohibited from enrolling individuals in
18
the Medical Assistance Program as the result of federal
19
approval of a State Medicaid waiver on or after June 14, 2012
20
(the effective date of Public Act 97-687), and any individuals
21
enrolled in the Medical Assistance Program pursuant to
22
eligibility permitted as a result of such a State Medicaid
23
waiver shall become immediately ineligible.
24

Effective October 1, 2013, the determination of
25
eligibility of persons who qualify under paragraphs 5, 6, 8,
26
15, 17, and 18 of this Section shall comply with the

HB1568
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LRB104 06181 KTG 16215 b
1
requirements of 42 U.S.C. 1396a(e)(14) and applicable federal
2
regulations.
3

The Department of Healthcare and Family Services, the
4
Department of Human Services, and the Illinois health
5
insurance marketplace shall work cooperatively to assist
6
persons who would otherwise lose health benefits as a result
7
of changes made under Public Act 98-104 to transition to other
8
health insurance coverage.
9
(Source: P.A. 101-10, eff. 6-5-19; 101-649, eff. 7-7-20;
10
102-43, eff. 7-6-21; 102-558, eff. 8-20-21; 102-665, eff.
11
10-8-21; 102-813, eff. 5-13-22.)

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