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HB 3780

Relating to producer responsibility; declaring an emergency.

2025 Regular Session Introduced by Em Levy

Establishes an Illinois statewide, publicly administered universal health system with full benefits, no cost sharing, and global budgets, reshaping insurers and provider ownership.

In committee upon adjournment.
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Bill Summary · HB 3780

Summary — HB 3780 (Illinois Universal Health Care Act)

Status & procedural history
- Introduced by Rep. Barbara Hernandez (first reading 2/18/2025).
- Filed with Clerk 3/5/2025; public hearing held 3/25/2025.
- Read first time 3/26/2025; referred to committee(s). In committee upon adjournment (6/28/2025).
- Title includes “declaring an emergency” (indicating intent for immediate effect upon enactment).

Purpose
- Establish a statewide, publicly administered universal health care system to provide comprehensive health coverage to all individuals residing in Illinois, contain costs, and improve population health. The Act is drafted to integrate with any future federal system.

Key components and provisions
1. Universal coverage and enrollment
- All Illinois residents are eligible and “covered under the Illinois Health Services Program.”
- Residents receive an Illinois Health Services Insurance Card with a unique number; Social Security numbers are not used for registration.

  1. Covered benefits

    • Broad, medically necessary coverage including primary/specialty care, inpatient/outpatient care, emergency care (emergency care covered anywhere in the U.S.), prescription drugs, durable medical equipment, long‑term care, mental health, full-scope dental (excluding elective cosmetic), substance-use treatment, chiropractic, and basic vision care.
    • No deductibles, copayments, coinsurance, or other cost sharing for covered benefits except for services that exceed the Board‑defined basic benefits.

  2. Provider participation and patients’ choice

    • Participating providers must be licensed and meet state/regional quality and staffing guidelines. Suspended/revoked licensees cannot participate.
    • Patients retain free choice among participating providers, hospitals, and inpatient facilities.
    • Only non‑profit HMOs that directly deliver care in their own facilities and directly employ clinicians may participate.

  3. Reimbursement & financing

    • Hospitals, nursing homes, community health centers, non‑profit staff‑model HMOs and home‑health agencies receive annual global budgets (monthly lump sums) negotiated with the Program. Global budgets cover operating expenses; capital investments are to be funded/separately allocated and overseen by regional health planning districts. The bill limits use of operating funds for excessive executive income, marketing, and major capital purchases.
    • Physicians/practitioners may choose fee‑for‑service (paid under an annually negotiated fee schedule), salaried employment, or global/capitated arrangements. Investor‑owned HMOs and group practices would be converted to non‑profit status.
    • Establishes the Illinois Health Services Trust as a financing vehicle for the Program.

  4. Pharmaceuticals & medical supplies

    • Single statewide prescription‑drug formulary and list of approved durable medical goods/supplies.
    • Creates a Pharmaceutical and Durable Medical Goods Committee to negotiate prices with suppliers/manufacturers via open competitive bidding and bulk purchasing; therapeutic substitution favoring lowest‑cost equivalent allowed with medical‑necessity exceptions.

  5. Restrictions on private and investor ownership

    • Private health insurers are prohibited from selling coverage that duplicates Program benefits.
    • Investor ownership of health delivery facilities is declared unlawful.

  6. Administration, claims, employment

    • Sets standards for claims billing and patients’ rights.
    • Program employees to be compensated in accordance with current State employee pay scales and as determined appropriate by the General Assembly.

Who would be affected
- All Illinois residents (automatic eligibility).
- Health care providers and institutions (licensing, participation rules, reimbursement model changes).
- Private insurers (prohibition on duplicate coverage would reshape commercial market).
- Investor‑owned health facilities and investor‑owned HMOs/group practices (would face conversion or prohibition).
- Drug manufacturers, durable medical goods suppliers (subject to centralized negotiating/bidding).

Potential impacts (observations)
- Moves Illinois toward a single‑payer / publicly administered universal coverage model with comprehensive benefits and largely no point‑of‑service cost sharing.
- Significant restructuring of provider payment (global budgets, salary/capitation options), ownership rules (non‑profit requirement), and the private insurance market.
- Centralized purchasing and formulary authority could reduce drug/supply costs but would shift negotiating power to the State.
- Declared emergency suggests immediate implementation timelines upon enactment; substantial operational, fiscal, and regulatory transition would be required.

Compiled from official sources — confirm details with the bill’s official record.

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