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Illinois Medicaid to boost abortion reimbursement rates

Crain's Chicago Business

Friday, August 5, 2022  |  Column  |  Katherine Davis

The program will increase reimbursement rates by 20% next month, an adjustment aimed at supporting and funding the state’s abortion providers.

Illinois’ Medicaid program will soon begin paying more to cover the cost of abortion services as the state works to bolster reproductive health access in a post-Roe v. Wade nation.

Beginning Sept. 1, Illinois’ Medicaid program will increase reimbursement rates by 20% for abortion services, Gov. J.B. Pritzker announced during a press conference on Thursday at the Chicago Family Health Center, which has several clinics on the South Side.

The change is aimed at better supporting and funding the state’s abortion providers, many of which have seen an influx of patients from nearby Midwestern states since Roe was overturned in June. The governor's office expects the reimbursements to cost around $3 million annually.

“Since the Supreme Court overturned Roe v. Wade, our reproductive health providers have been working overtime to ensure that every patient has access to the reproductive care that they’re entitled to,” Pritzker said.

Illinois Medicaid first began covering abortions in 2018. A year later, Pritzker signed the Illinois Reproductive Health Act, which made abortions a fundamental right in the state and required most private health insurance plans in Illinois to cover abortion as they do for any other pregnancy care.

Pritzker on Thursday also said that his office is working to get reimbursement payments to providers more quickly by eliminating billing hurdles in the state’s Medicare and Medicaid programs.

Additionally, the Illinois Department of Public Health is expanding the state’s family planning program by providing an additional $2 million in grants to reproductive health organizations around the state. The new funding brings the state’s total Title X budget to more than $13 million, Pritzker said.

The Title X program is a federal initiative that Illinois resumed participation in earlier this year. Illinois refused to participate in the program during Donald Trump’s administration to protest its policy prohibiting the program’s funds be used to counsel patients about abortion or referring them to abortion providers.

“This additional investment means more Illinoisans will receive quality, accessible family-planning services like pregnancy testing, basic fertility services, STD tests and cancer screenings,” Pritzker said.

The additional funding, as well as the increase in Medicaid reimbursement, will help providers like Planned Parenthood of Illinois, one of the state’s largest abortion providers.

“The things that the governor announced today definitely are helpful,” says Brigid Leahy, vice president of public policy at Planned Parenthood of Illinois.

About 44% of PPIL’s patients in 2021 qualified for Medicaid coverage. The increased Medicaid payments won’t alleviate PPIL’s biggest challenge, however.

Since Roe fell, Leahy says PPIL’s 17 clinics around the state have seen an influx of out-of-state patients, a reality that was expected. But because these patients aren’t Illinois residents, they don't qualify for the state’s Medicaid program, Leahy says. Most out-of-state patients pay with private insurance, out of pocket or with assistance from organizations like the Chicago Abortion Fund. An abortion can cost up to $750, according to Planned Parenthood.

Before Roe was overturned, PPIL saw about 100 out-of-state patients seeking abortions per month. But in the month after the Supreme Court’s decision, Leahy says the organization had about 800 out-of-state patients booked for abortion appointments. PPIL previously told Crain’s that it typically provides about 1,000 abortions specifically for out-of-state patients every year, which includes abortions given through at-home medications and in-clinic procedures.

Many out-of-state patients were flocking to PPIL’s clinics located on Illinois’ borders or centrally located, but now they’re more frequently visiting the organization’s centers around the state.

“We are now seeing patients everywhere because they are trying to get in wherever there’s an opening,” Leahy says. “We’re doing our best to accommodate them.”

Many are coming from Illinois’ neighboring states, like Wisconsin and Ohio, but others are coming from as far as Florida and Texas, Leahy says.

Data shows women from other states have long come to Illinois for abortions. Across all health care providers, about 46,000 abortions were performed in Illinois in 2020, the most recent data available, according to the Illinois Department of Public Health. Of those patients, more than 9,600 were women from out of state, up from about 7,500 in 2019 and 2,000 in 2015.

Illinois Right to Life, an anti-abortion organization, has been vocal on its opposition to Illinois’ abortion laws. When PPIL partnered with Planned Parenthood of Wisconsin last month to bring physicians to Illinois to perform abortions, Illinois Right to Life said PPIL was looking to protect its revenue streams.

Illinois Right to Life did not immediately respond to a request for comment from Crain’s on Thursday.