A 2021 study by the Illinois Department of Healthcare and Family Services found that more than 900,000 Illinois residents are living without health insurance — and about a third of them qualify for Medicaid but are not enrolled.  

But, a bill passed in the Illinois House of Representatives this March aims to lower both of those numbers. 

If signed into law, House Bill 2719 would require that hospitals screen each uninsured patient for eligibility in state and federal health insurance programs and financial assistance programs when they are admitted. According to the bill, hospitals would not be allowed to pursue collection actions against patients if they did not complete screening requirements. 

State Rep. Dagmara Avelar (D-Bolingbrook), a sponsor of the bill, said the legislation aims to protect residents from “unnecessary medical debt.” She added that the bill could help immigrant and refugee communities, who she said historically have low healthcare enrollment numbers.

“Whether you were born here, whether you were first, second (or) third generation American when it comes to barriers to access to services, health care is probably one of the main things people are concerned about,” Avelar said.

In February, Avelar independently filed the bill in the Illinois House of Representatives. The bill is sponsored by 34 House members and three state senators as of Tuesday. It currently awaits a vote in the Illinois Senate.

HB2719’s introduction comes amid efforts in multiple states to limit residents’ medical debt. States like New Mexico and Minnesota have passed similar legislation in the past few years, requiring hospitals to screen uninsured patients for financial assistance programs.

According to a March 2023 study by the Illinois Coalition for Immigrant and Refugee Rights, in-state medical debt is disproportionately affecting communities with higher numbers of low-income Black and immigrant residents. The study also said a screening process could save hospitals money while also making it easier for patients to navigate the “complex health system.”

Avelar, who was director of programs for ICIRR from 2017 to 2023, added that language barriers can disrupt access to health care. 

HB2719 would require that hospital screenings and assistance are “culturally competent” and in the patient’s primary language.

Kathi Franklin, President and CEO of Cook County-based non-profit and health care service provider Access to Care, said the bill could benefit hospitals as well as patients.

“It’s good for the hospital because the hospital gets those services paid for, but it’s also great for the patient because the patient is likely going to need follow-up care,” she said.

Franklin also said she believes the bill will have a “tangible” impact on people in Evanston residents who are low-income. However, she added that some undocumented residents who Access to Care works with are afraid to enroll in health care programs.

Immigrants without permanent legal status are unable to enroll in Medicaid. 

According to Norrina Allen, the Quentin D. Young Professor of Health Policy at Northwestern’s Feinberg School of Medicine, though some patients may be hesitant, the new bill could help connect uninsured or underinsured individuals with resources. 

But, she added that supporters of the bill should make sure financial resources offered by hospitals are “fair for all individuals,” especially undocumented residents.

“Hopefully the resources that are considered and offered by health care institutions are broad and general and include a variety of services beyond just Medicaid,” Allen said. 

She believes the new legislation is especially important for younger people, aged 19 to 39, who are the least likely to have health insurance coverage. 

“If we can make sure that they are receiving preventative care and not incurring any additional debt and economic impact, then I think that will improve the health and well-being of the state,” Allen said.

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