State Rep. Sue Scherer asked fellow lawmakers April 6 to vote for legislation she said would protect patients harmed by the contract dispute between Blue Cross and Blue Shield of Illinois and Springfield Clinic.
Scherer, D-Decatur, whose 96th House district includes parts of Springfield’s east side and eastern Sangamon County, was unsuccessful in securing passage of House Bill 1463, even though she portrayed the vote as a test of lawmakers’ character.
“I hope to goodness people in this room have the courage to stand up to the ‘bad guys,’ because it’s quite clear tomorrow if I want to answer who’s owned by the insurance companies, guess what? I’m handing them a roll-call vote,” Scherer said, her voice cracking with emotion at the end of 45 minutes of debate on the measure.
The roll call showed 40 House members voting “yes,” 21 voting “no,” seven voting “present” and 46 not voting – meant the bill failed because it didn’t receive the required 60 or more votes to pass and move to the Senate.
Those not voting included Republicans and members of Scherer’s own party, who control the House and Senate. Joining Scherer in support of the legislation were Reps. Tim Butler and Sandy Hamilton, both Springfield Republicans; and House Speaker Emanuel “Chris” Welch, D-Hillside.
Those not voting included Rep. CD Davidsmeyer, R-Jacksonville, and House Minority Leader Jim Durkin, R-Western Springs.
Scherer said she doesn’t know whether she will try to pass the legislation in the future. The bill was supported by Gov. JB Pritzker, a Democrat, and the Pritzker administration’s Illinois Department of Insurance.
Scherer told Illinois Times she will continue to speak out about the need to hold health insurance providers more accountable.
“My bill was called to bring transparency and accountability to big insurance companies,” she said. “I care deeply about providing affordable, accessible health care to the residents of my district, and I will continue to work towards that goal and fight for my constituents, as always.”
HB 1463 covers 102 pages and would tweak the state’s Network Adequacy and Transparency Act, which was passed in 2017 and began affecting insurance plans in 2019.
The bill would allow state officials to confirm the existence of investigations of insurance companies. The bill also would create more stringent standards for insurance providers to maintain accurate online listings of doctors in their networks and more quickly adopt annual federal recommendations on the number of specialty doctors needed for “network adequacy.”
A news release from the state insurance department said the bill would give the department “the authority to put in place more stringent time/distance standards than current federal requirements for many specialties to ensure consumers can access in-network providers close to home.”
Scherer, the bill’s sponsor, said the state insurance department proposed the bill late in the spring legislative session because of regulatory gaps highlighted during Blue Cross’ year-long contract dispute with Springfield Clinic.
Scherer arranged for a hearing on the contract dispute in front of a House committee on March 30 in hopes of pushing both sides to a settlement. But she said the bill wasn’t intended to get in the way of a private contract negotiation.
Rep. Thaddeus Jones, D-Calumet City, chairman of the House Insurance Committee, criticized Scherer’s bill in debate on the House floor, saying she should have brought the bill to his committee for vetting instead of another House committee.
He also said Scherer didn’t do enough to get agreement on the bill from the insurance industry. Scherer said she tried to get the industry and other organizations involved, but not everyone responded to her invitations.
Jones said Scherer was “untruthful” in her description of the bill negotiation process, a claim Scherer denied.
“This bill is not only overkill, but this bill doesn’t solve the problem that you are seeking to resolve,” he said.
He noted that the Department of Insurance says it would cost the department $836,500 annually to carry out the legislation through the hiring of additional state workers, plus software and contractual costs.
Jones – who has received more than $24,000 in campaign contributions from the Illinois insurance industry since early 2018, according to the nonprofit Reform for Illinois organization – didn’t return a phone call from Illinois Times.
The insurance industry opposed the bill. Laura Minzer, president of the Illinois Life and Health Insurance Council, said her organization would support some parts of the bill, including making insurance plan investigations public, but not other parts of the bill. The council would be willing to negotiate future legislation with Scherer, Minzer said.
Jones and other lawmakers opposing HB 1463 said the legislation wouldn’t result in a contract settlement between Blue Cross and Springfield Clinic, but Scherer said that wasn’t her goal with the legislation.
Other lawmakers questioned the need for the bill when administrative rules to clarify parts of the current Network Adequacy and Transparency Act were proposed by the insurance department recently and could go into effect in several months.
But Scherer said her bill would complement the proposed rules.
She said on the House floor that passage of the bill would allow lawmakers to know they “stood up for” their constituents and “had the courage to stand up to the insurance lobbyists, and we all know that’s not a small thing.”
The dispute between Blue Cross and Springfield Clinic has resulted in thousands of central Illinois residents losing in-network access to their doctors, physician assistants, advanced-practice nurses and other providers.
Springfield Clinic officials said last year that the dispute threatened to disrupt the care of more than 100,000 patients. Blue Cross officials disputed that number and said about 55,000 Springfield Clinic patients, at the most, were affected by the change.
Since then, some employers have switched insurance carriers to retain the clinic as an in-network provider and protect employees from higher out-of-pocket costs when they seek care from clinic providers.
The dispute hasn’t been resolved.
Chicago-based Blue Cross, the biggest insurance company in the state, recently agreed to pay a $339,000 fine to the Department of Insurance for delaying the filing of documents backing up Blue Cross’ claim that it has an adequate network even with the loss of more than 600 Springfield Clinic providers.
The department continues to evaluate Blue Cross’ “network adequacy” filing, department spokeswoman Caron Brookens said.
Dean Olsen is a senior staff writer for Illinois Times. He can be reached at dolsen@illinoistimes.com or 217-679-7810.
This article appears in Spring Home & Garden 2022.
