Q&A: Illinois State Rep. Dagmara Avelar discusses healthcare bills and the importance of ensuring implementation 


Maddie McCarthy


The Illinois General Assembly reconvened on Jan. 16th to continue the state’s 103rd legislative session.

In this Q&A, state Rep. Dagmara Avelar (D-Bolingbrook) sat down with State of Reform and discussed health-related bills she is sponsoring and her hopes for the rest of the session.

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State of Reform: Your legislation, House Bill 2719, which requires hospitals to screen uninsured patients for assistance eligibility, passed last year and went into effect on Jan. 1st. Can you speak to the impact you anticipate this bill will have, and any information you can provide about implementation plans for it?

Rep. Dagmara Avelar: With HB 2719, when it comes to impact, within the first week when we announced that this had been passed by the House as well as the Senate and then it was sent to the governor to sign, I had multiple community partners—primarily folks who are in the trenches, whether as the nurses, the quality care managers, etcetera—just saying how much this was going to help.

In their leadership meetings or staff meetings, they were already talking about some of the changes that hospitals needed to do to proactively look for some potential eligibility for people to be able to access healthcare.

One of the things that we know, right here in Illinois, is that at this moment there are thousands of people who are currently eligible for Medicaid and do not know.

When it comes to HB 2719, this legislation goes to the core of some of my primary priorities as a state legislator, which is to improve the healthcare outcomes of not just my constituents but all Illinois residents by maximizing all of our resources that are at our disposal.

I’m very well aware that stakeholders like the Illinois Hospital Association as well as advocates who worked with me on this bill are currently working on curriculum to continue to provide training, particularly to hospital staff so that they are able to provide information to uninsured people for them to be able to get the best care possible.

I love passing legislation, but I truly think that it’s important for us to look at where we are on implementation because usually that’s where things fall through the cracks.

SOR: Are you planning to pursue health legislation this year that you supported last year that didn’t pass? For example, HB 2050 (which would allow for Medicaid-covered medically necessary orthodontics) or HB 2280 (which would require cultural competency training for healthcare providers)?

DA: In Illinois, we have a Medicaid working group which is a bicameral, bipartisan group of legislators who look at how we can better improve our Medicaid system. So we look at budgetary concerns as well as legislative policy concerns, and we are at the table with the Department of Healthcare and Family Services which manages our Medicaid system here in Illinois.

So with these particular bills for example, HB 2280 as well as HB 2050, we actually tend to have conversations to be able to negotiate these bills so they are part of bigger packages when it comes to healthcare.

So 2050, for example, was part of the Medicaid omnibus bill (HB 1298), which was led in the House by majority leader Rep. Robyn Gabel. 

HB 2280 was actually a bill that was heavily negotiated with the Illinois Medical Society and that became an agreed bill. HB 2450 … is a strong and targeted bill that does what it has set out to do, which is create an avenue for cultural competency courses to be available for healthcare providers, but then also allowing the choice for healthcare providers to choose which cultural competence course within their required courses to be certified here in the state of Illinois to practice, to fit their needs when it comes to the patients that they serve.

SOR: I see you filed HB 4358 at the beginning of January, which would amend the Mental Health Early Action on Campus Act and require public colleges and universities to develop and implement a mental health and suicide prevention plan. Could you talk about why this bill is needed? Do you foresee any obstacles to its implementation?

DA: I’m very hopeful about the breaking down of barriers when it comes to access to mental healthcare and behavioral healthcare, and being okay talking about the fact that just as we look at preventative care from the physical side, that we could also take a look at it from the mental health point of view.

I think this is one of those bills that wants to add onto that conversation with regards to mental health on campuses. This idea was brought to me by a constituent, and what we are trying to do is we’re actually trying to play up on the strengths of the legislation that we already have.

For example, last year the state of Illinois passed some really good legislation focusing on services as well as resources when it comes to higher education and truly putting our money where our mouth is. If you want to make sure that people are able to go to college if they wish to, that the state should also put part of our investment when it comes to the budget towards that goal. 

We set aside millions of dollars, not just for Monetary Award Program (MAP) grants, which allow people who are low and median income class to go to school, but then also for some of those resources to go particularly for mental health.

Currently there are resources and there is this technical assistance center, which is actually something that was thought out last session. What I’m trying to do with this particular bill is have this technical assistance center that is going to be helping higher education come up with better plans, and to also have them come up with a mental health and suicide prevention template.

SOR: What do you anticipate to be the biggest themes of healthcare policy making in the rest of this session? From your position on various committees, are there any particular subjects you expect to be points of focus? What else do you look forward to in the session?

DA: The theme for this year continues to be the same, which is, ‘What is it that we as a state legislature need to do in order to be able to improve the health outcomes of our community?’ 

I continue to be part of the Medicaid working group as well as pursuing other initiatives to remove barriers to the life-saving healthcare that people need. 

Our state budget is always a focal point when it comes to public health spending, and it’s one of our major line items here in Illinois. So I’m pretty sure that we will have plenty of big conversations around how all of this gets broken down.

There was major news last year with the passage of the state-based exchange, which I actually look forward to working on with my colleagues in the assembly as well as the Department of Insurance so that we can move towards implementation of this important program. I sound like a broken record, but we want to look at implementation to increase the healthcare outcomes of our communities. 

I think one thing that we’ll see this session also is continued conversations as well as pieces of legislation that tackle coverage of prescription drugs or transparency in pricing. I think that is something a lot of constituents, not just in my district but in Illinois, care about. 

My pivotal role in doing this type of work is just making sure that we are looking at any legislation in a holistic manner, where we talk about not just the patient, but also the provider. We’re talking about the health of the system that provides that care, creating a better community. Whatever we need to do to increase healthcare outcomes or to make them better, I want to be able to get them done.

Where is it that we might be doing well in implementation? Where is it that we could have improvements? One thing is us legislating, but it’s a whole other ballgame to be implementing. That is one of the things that I want to focus on this year is making sure that we are evaluating how legislation that’s being passed and becoming law is actually helping everyday Illinoisans.

This Q&A has been edited for clarity and length.

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