Illinois aims to reduce Medicaid ‘churn’ and improve health outcomes by moving to 12 months of continuous coverage for all adults

Under one of the first federal laws passed in response to the COVID-19 pandemic, states were offered a deal on Medicaid that every single one opted to take.

Allow covered individuals to stay continuously enrolled in the health insurance program through the course of the public health emergency, U.S. lawmakers said, and we’ll boost the federal Medicaid match rate (by 6.2 percentage points).

Coming up on three years, the public health emergency remains in place. But when it ends, potentially as soon as Jan. 11, 2023, so will this big, albeit temporary, change in health policy.

The Center for Children and Families at Georgetown University’s Health Policy Institute estimates the emergency’s end will mean about 80 million people nationwide could have their Medicaid status reviewed as states revert to their pre-pandemic policies on coverage status.

When that happens, the Kaiser Family Foundation says, between 5.3 million and 14.2 million Medicaid recipients could lose coverage due to status changes.

But a handful of U.S. states have taken steps to make 12-month continuous coverage for adults a permanent part of their Medicaid programs.

Illinois is the first, and thus far only, Midwestern state to do so.

Illinois’ waiver request

Signed into law in early April, HB 4343 requires the Illinois Department of Healthcare and Family Services to seek the necessary federal waiver.

If this request is granted, 12 months of continuous eligibility will be extended to all Illinois adults on Medicaid — with or without a national public health emergency in place.

Illinois Rep. Mary Flowers’ work on the issue predates the pandemic and the subsequent temporary changes in federal policy.

She believes that by guaranteeing 12 months of enrollment, the state will ensure a continuum of care for low-income people, who are less likely to seek care if uninsured.

Without a blanket policy of continuous coverage, an individual can lose his or her Medicaid benefits for many reasons — changes in income or family status, for example, or bureaucratic barriers to renewing one’s status, the Kaiser Family Foundation notes.

Currently in Illinois, Flowers says, 12 months of continuous eligibility only applies to adults in the state’s Medicaid managed-care program (HealthChoice Illinois). The policy does not extend to other Medicaid enrolled adults.

“It just didn’t make sense to me that every eight months there was a redetermination process [for adults not in the HealthChoice program],” says Flowers, a sponsor of this year’s HB 4343.

Nor did it make sense that if a mother lost her coverage for whatever reason, her whole family suffered the loss of coverage, too, she adds.

Temporary gaps in care

The process of enrollees losing Medicaid coverage due to short term changes in income and/or other circumstances, and then re-enrolling within a short period of time, is known as “churn.”

Nationally, the churn rate is estimated at 10.3 percent of Medicaid enrollees, says Jennifer Tolbert, director of state health reform and associate director for the Kaiser Family Foundation’s program on Medicaid.

“One of the advantages of continuing enrollment is you eliminate that churn, those temporary gaps in coverage that create administrative problems and hurdles for the people covered,” Tolbert says.

Georgetown’s Health Policy Institute noted in a July 2021 report that continuous eligibility can help Medicaid recipients and programs alike: Mitigate the harmful effects of income volatility for low-income families and essential workers, and reduce administrative costs so that states can “dedicate more of the Medicaid dollar to pay for health care.”

State policies on children

States already have the option of providing 12 months of continuous coverage to children.

Close to half of the U.S. states do this in their Medicaid and/or their Children’s Health Insurance Programs (CHIP).

That list of states includes seven in the Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, North Dakota and Ohio.

Such a change requires states to amend their Medicaid plans, Tolbert says.

The process is different, and more difficult, for extending this continuous-coverage policy to the general adult population. States must apply for and secure a Section 1115 waiver, so named for the part of federal law that permits some experimentation with Medicaid programming. The waiver requires that any increase in costs be offset with savings elsewhere in a state’s Medicaid program.

Tolbert says just three states provide 12-month continuing enrollment for adults independent of federal pandemic aid (Montana, New York and Utah) — and only to narrowly targeted groups such as single adults below a certain income level or those with serious, disabling mental illnesses.

Illinois will join them if the U.S. Centers for Medicare & Medicaid approves the state’s waiver application (not yet submitted as of late October).

Decisions ahead for states

Under the American Rescue Plan Act, states also can provide 12 months of continuing enrollment for postpartum women. In the Midwest, Illinois, Indiana, Kansas, Michigan, Minnesota and Ohio have done so.

Tolbert says the benefits of 12-month continuous coverage for all adults are worth the effort to seek the waiver.

“One thing we do know is having coverage improves access to care,” she says. “People who are uninsured have much higher rates of not getting care. Having continuous enrollment can improve health outcomes.

“We’ve just had a natural experiment with keeping people on continuous coverage for two years where states haven’t been able to disenroll anyone,” she adds.

“I think, given this experience, a number of states are now looking at ways to potentially extend [coverage].”

Once the national public health emergency ends, states will begin reviewing the status of their Medicaid enrollees.

A Kaiser Family Foundation survey found that most states plan to take up to a year to make eligibility determinations. Federal guidance calls on all states to complete their renewal process within 14 months.

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New Assessment Tool Helps Jurisdictions Build and Implement Successful Community Responder Programs

Jurisdictions across the country are reimagining their approach to public safety by investing in community responder programs that position health professionals and community members trained in crisis response as first responders.

To support these efforts, the CSG Justice Center recently released the Expanding First Response Assessment Tool—a web-based resource designed to help communities determine where they are in planning, implementing, and sustaining a community responder program in less than 15 minutes. The tool gives users the choice to take one of five assessments to either determine their readiness for the program, how well their implementation is going, and/or whether they have the tools to sustain their program.

Once selected, communities can assess their progress and learn about next steps to building a fully operational program unique to their community’s needs. Users receive a summary of their results and resources to aid their progress or amplify their success story upon completion. Tool guidance can range from information on best practices drawn from research to online resources and connections to existing community responder program managers and staff.

“The assessment tool provides valuable insight and practical information for areas exploring alternative responses. It will cover all your bases and guide you and your agency in involving everyone—from community members to stakeholders—in your development and implementation process,” said Carleigh Sailon, Denver STAR operations manager, who reviewed the tool ahead of its launch.

The Expanding First Response Assessment Tool is a complementary component of the groundbreaking toolkit, Expanding First Response, which was launched last year. The toolkit serves as a central hub for local communities and states looking to establish or strengthen community responder programs, as well as to learn from existing programs’ successes and challenges.

Topics covered by the assessment tool follow the organization of the toolkit, including:

Community Engagement
Needs Assessment
Program Staffing
Call Triaging
Use of Data to Inform Decision Making
Safety and Wellness
Financial Sustainability
Legislative and Policy Strategies

“Community responder programs have the potential to create a public safety system built around care instead of unnecessarily punitive responses,” said Ashtan Towles, senior project analyst in the Behavioral Health Division of the CSG Justice Center. “We have worked to build the Expanding First Response Assessment Tool to help practitioners across the country determine what they need to successfully develop and sustain such programs.”

 

 

The Expanding First Response Assessment Tool is supported by the Alkermes Inspiration Grants Program, which is funded by Alkermes, Inc.–a global company funding impactful nonprofit organizations that support people affected by addiction, serious mental illness, and other adversities.

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Farewell From the Chair: A Conversation with Idaho Representative Clark Kauffman

After ten years of service in the Idaho Legislature, Representative Clark Kauffman, CSG West Chair, will be departing the legislature at the close of this term, which ends November 30. CSG West had a recent opportunity to interview Representative Kauffman about his experience as a legislator and as CSG West Chair, his advice to incoming legislators, and thoughts on the most important issues facing the West.

The CSG West family extends its gratitude to Representative Kauffman for the leadership, character, and service that he demonstrated. We wish him and his wife, Debbie, success in all their future endeavors.

There are a substantial number of first-time lawmakers that will begin serving in 2023. What advice would you offer a freshman legislator?

I think if you’re a freshman coming in, you need to realize that you look at life and legislation through a certain set of lenses. Don’t be afraid to explore what other people’s lenses are. There are just so many sides to every issue. Don’t be in a hurry to put a stake in the ground on an issue until you have really taken the time to vet it and look at it from everybody’s different lenses. You might be surprised… you might find out you don’t really know what you’re talking about.

Prior to your legislative service, you served on several local and state boards in Idaho. What motivated you to run for the legislature in 2012?

In those local positions I dealt with the legislature on issues that were important to transportation or to agriculture, so I was somewhat familiar with it. When redistricting occurred, there was an open seat in my district and several of the sitting legislators in the area came to me and said, “it’s your turn.” In my involvement with transportation and agricultural advocacy groups, I believed that my skill set would serve the needs of District 25. My farm was at a point that I thought I would have the time to , and I threw my hat in the ring. It was a close election in the primary, but it seemed like the timing was right and an opportunity was there.

Can you comment on your experience being an officer of CSG West? Is there a memorable moment that stands out?

That’s been a highlight of the whole 10 years I’ve been in. I thought it was really a great experience to host the Annual Meeting in Boise. I think we had good speakers, good attendance, and good weather. If there was a highlight, that would be it – having a successful Annual Meeting in my home state.

Is there anything else that you’d like to share about your experience with CSG West?

The thing I want everybody to know about CSG West is that the staff meets 110% or more of expectations. I’ve had nothing but admiration for the work that you do – and how you get it done so efficiently and quickly. My hat goes off to the staff of CSG West.

What would you describe as the most important issue shaping the West right now?

There’s probably five or six “number ones,” but for me, drought is a major issue. The population continues to grow and there’s only so much water. I think that CSG West starting the Colorado River Forum is going to payoff big time in the future. I’m excited about that. It covers a great number of our western states from Montana to Mexico. If the folks that are impacted don’t start visiting with each other, there’s never going to be happiness.

At this year’s Annual Meeting your colleagues offered their comments and best wishes as you prepare for your next chapter. A theme that ran through their remarks, regardless of party affiliation, was the value you place on building relationships. Can you comment on that?

That’s certainly the way I want to be remembered… being fair and open to everybody’s opinions. Not that you’re going to agree, but that you don’t have to be disagreeable when you don’t agree. I just think living life that way is a lot more productive. For me, it’s so I can go to sleep at night without holding animosity towards anybody. I took how I wanted to live life with me when I went to the legislature. I didn’t change or become something different.

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10 Midwestern states, 10 new laws enacted in 2022 with bipartisan support

In a given year, hundreds, sometimes thousands, of bills are introduced in a single state legislature. The highly partisan measures often receive the most public attention.

But then, as Michigan Senate Majority Floor Leader Dan Lauwers noted in an interview earlier this year with CSG Midwest, there are the “95 percent” — bills that aren’t strictly partisan, can gain widespread support, and can make a positive difference in people’s lives.

As the calendar year winds to an end, CSG Midwest is looking back at the 2022 legislative sessions with a focus on laws enacted with bipartisan support. For each of the 10 states where legislators met (North Dakota only holds session in odd-numbered years), we identified one such law.

Michigan invests big in new scholarship program

When young people across Michigan graduate from high school this spring, a vast majority of them will be eligible for state-funded scholarships to attend college. An initial investment of $250 million is being made as part of the state’s FY 2023 budget, with legislators coming to final agreement this fall on the new Michigan Achievement Scholarship.

Under SB 842, a qualifying student will receive as much as $27,500 ($5,500 per year, for up to five years) to attend one of Michigan’s public universities. Alternatively, he or she could get up to $8,250 (over three years) to attend a community college, $20,000 (over five years) to attend a private postsecondary school, or $2,000 to take part in job training. Some of this money comes in the form of a first-dollar scholarship; some is last-dollar (tuition costs are covered only after other financial aid has been used).

Students will be eligible for the scholarships if their family demonstrates a financial need when they complete the Free Application for Federal Student Aid.

According to Gov. Gretchen Whitmer, 94 percent of Michigan students attending community colleges and 76 percent going to a public university will qualify.

SB 842 was passed by the Michigan Senate without a single “no” vote and by a vote of 78-26 in the House (five members did not vote). Gov. Gretchen Whitmer signed the measure in October.

Wisconsin stiffens penalties to protect health care workers from threats and violence

Amid reports of increased violence against health care workers across the country, Wisconsin legislators advanced a measure in early 2022 that enhances penalties for perpetrators of these crimes.

AB 960 was signed into law in March, building in part on a measure from two years ago that made battery to a nurse a felony rather than a misdemeanor. (In Wisconsin, the crime of battery is typically a misdemeanor.) Under the 2022 law, if an individual “intentionally causes bodily harm” to any person working in a health care facility, he or she faces potential felony charges — punishable by up to six years in prison, a fine of up to $10,000 or both.

A threat of violence to these workers, as well as their family members, also is now a felony, if it is “a response to an action occurring at the health care facility.”

AB 960 passed the Wisconsin Assembly and Senate with only a single “no” vote. Gov. Tony Evers signed the law in March.

Minnesota offers help for drought-hit farms, seeks broadband expansion

In Minnesota, the only Midwestern state with a split-control Legislature in 2022, leaders from both parties came together on a bill (HF 3420) to support drought-impacted farmers as well as bring broadband to the state’s hardest-to-reach areas.

Checks of up to $3,143 were sent this summer to nearly 3,000 Minnesota livestock farmers and specialty crop producers. To apply for these state payments, a producer’s farm operation had to be located in a county or nearby county designated as a natural disaster area due to drought conditions during the latter half of 2021. Another $2.5 million was appropriated for drought-relief loans and $5 million for reforestation.

Minnesota also is using a mix of federal and own-state dollars to close gaps in broadband access. New with this year’s passage of HF 3420: a pilot program that enhances the state’s funding match for projects that get high-speed internet to lower-density areas. Typically, qualifying projects have been eligible for state grants equal to 50 percent of the total costs. The $30 million pilot program allows for a 75 percent match if lower grant amounts are “not adequate to make a business case for the extension of broadband facilities.”

HF 3420 passed the House by a vote of 69-64 and the Senate by a vote of 66-1. Gov. Tim Walz signed the measure in May.

Iowa, a national leader on ethanol production, adopts first-of-its-kind E15 mandate

Extensive legislative negotiations over the future of ethanol policy in Iowa culminated with bipartisan approval of a bill that establishes the nation’s first E-15 mandate.

HF 2128 requires most retailers to sell gasoline with a blend of 15 percent. Exemptions from the mandate are available for smaller gas stations (those that sold less than 300,000 gallons of gas in 2020) or locations with incompatible equipment. To help retailers make the necessary infrastructure changes, legislators have created a three-tiered system of grant funding, with the state covering anywhere from 70 percent to 90 percent of the costs depending on the size of the gas station and whether it already had been selling E-15 blends. Additionally, infrastructure grants are available for businesses that sell biodiesel blends of 20 percent or more.

Another provision in HF 2128 increases the state’s per-gallon biodiesel tax credit and extends it through 2027.

HF 2128 passed in the House by a vote of 81-13 and in the Senate by a vote of 42-3. Gov. Kim Reynolds signed the measure in May.

Ohio expands rights of students to religious expression

Three years ago, as a cross-country runner on her local high school team, Noor Alexandria Abukaram was disqualified from a race because of a hijab she wore during the competition.
Soon after that incident, she began working with legislators on getting a bill on freedom of religious expression to the finish line.

That work paid off with this year’s SB 181, which generally prohibits a school or interscholastic athletics organization from preventing the wearing of religious apparel (headwear, clothing, jewelry or other coverings) during athletic or other extracurricular events. An exception is made for any apparel that poses a “legitimate danger to participants.”

Prior to the law, under Ohio High School Athletic Association rules, student athletes were banned from wearing head coverings unless they had been granted special permission prior to the event. Now, schools, conferences and the state association cannot require students to secure advanced approval or written waivers.

SB 181 received unanimous approval in the Ohio House and Senate; Gov. Mike DeWine signed the bill in February.

Nebraska targets financial help for teachers early in their careers

Nebraska needs more teachers, and a new law aims to attract more young people to the profession. Under LB 1218, the state will spend up to $5 million a year to help full-time classroom instructors repay their loans; the total amount of assistance for an individual teacher could be as much as $25,000 ($5,000 annually for up to five years).

The law also expands the reach of Nebraska’s existing Attracting Excellence to Teaching Program, under which early-in-their-career teachers have been eligible for loan forgiveness (up to $3,000 annually, for up to five years, and a higher amount for being employed in high-need districts). A provision in LB 1218 now makes student teachers in Nebraska eligible for up to $1,000. The same measure makes changes to the teacher certification process, in part to make it easier for individuals with out-of-state licenses to secure work in Nebraska.

Additionally, the State Board of Education can no longer require passage of a state-administered basic skills exam as a prerequisite for young people to enter Nebraska’s teacher-education programs.

LB 1218 passed on a vote of 46-0-3 in the Unicameral Legislature; Gov. Pete Ricketts signed the bill in April.

Illinois defines and cracks down on organized retail theft

Illinois has defined a new crime of “organized retail theft,” and is providing law enforcement with additional tools to combat it. Lawmakers are targeting criminal enterprises behind some of the looting and smash-and-grab robberies of big box stores, auto dealers and other retailers.

This stolen merchandise is sometimes then sold via online marketplaces, with the proceeds used to fund other illegal activities such as gun and drug trafficking.

Under HB 1091, local prosecutors can fully pursue cases of organized retail theft when the crimes cross multiple jurisdictions. Additionally, the state attorney general’s office can investigate and prosecute these cases through the convening of a statewide grand jury. Illinois’ new law also requires online retailers to verify the identity of high-volume sellers, and establishes a state-level intelligence-gathering platform to improve communication among retailers and law enforcement.

HB 1091 was passed 96-5-2 in the House and 42-10 in the Senate; Gov. J.B. Pritzker signed the bill in May.

Indiana has new statutory language to prevent ‘slumlord purchases’

Indiana has new statutory language to keep foreclosed homes and other properties out of the hands of unscrupulous, sometimes out-of-state investors. According to The Indianapolis Star, HB 1048 originally was introduced to allow local sheriffs to conduct online sales of foreclosed properties (in-person sales had been required).

Such a move raised concerns among some lawmakers, though, who said it could worsen the problem of absent, faraway slumlords gobbling up properties in Indiana neighborhoods and taking advantage of lower-income households.

The bill was amended to prohibit certain individuals from acquiring foreclosed properties at sheriff’s sales — those with housing-code violations against them or who are delinquent in paying taxes. In addition, any bidder on a foreclosed property must sign an affidavit affirming that he or she is not making the purchase on behalf of a prohibited buyer.

HB 1048 passed both legislative chambers by wide margins: 50-0 in the Senate and 86-3 in the House. Gov. Eric Holcomb signed the bill in March.

Kansas adopts new tax credits, loan guarantees to spur development of rural and affordable housing

Citing a continued lack of affordable housing as an impediment to economic growth, Kansas legislators have established a series of new tax credits and loan guarantees. HB 2237 focuses particularly on building up the housing stock in Kansas’ rural areas. For developers who build in the state’s smallest counties (fewer than 8,000 people), an income tax credit of $35,000 per new housing unit now is available. Smaller credits are in place for developers of housing in other small or midsized counties.

In addition, a total of $2 million in loan guarantees is going to projects that build new homes or rehabilitate existing ones in Kansas’ smallest counties (fewer than 10,000 residents). The guarantee, capped at $100,000 per home, is an attempt to address the problem of construction costs sometimes coming in higher than a home’s appraised value.

Separately, Kansas’ budget (SB 267) directs additional dollars to a program that assists smaller communities looking to spur the construction of moderate-income, workforce housing. The new money, a total of $20 million, comes from American Rescue Plan Act funds. Legislators also are using $20 million in general-fund dollars to establish a Rural House Development Revolving Loan Program.

The Kansas House and Senate passed HB 2237 with final votes of 109-12 and 34-3, respectively. Kansas’ final budget agreement also received widespread, bipartisan support. Kansas Gov. Laura Kelly signed the budget in April and HB 2237 in May.

South Dakota takes steps to become national leader in protecting agriculture sector from cyber attacks

South Dakota legislators took steps this year to position the state as a national leader in protecting its No. 1 industry, agriculture, from cyber-related attacks. Under HB 1092, $1.25 million is being allocated for two of the state’s public universities to partner on new research, undergraduate and graduate curricula, and outreach to farmers and ranchers about cyber threats.

Among the goals of this new law: build a workforce pipeline in the state for the cybersecurity industry, a sector that South Dakota has targeted for new investments and economic growth.

Because of a legislative appropriation four years ago, South Dakota State University became the first school in the country to offer a bachelor’s degree in precision agriculture. Its partner on this new CyberAg Partnership Initiative is Dakota State University, which has been designated as a “Center of Academic Excellence” by the federal government.

HB 1092 passed 53-15 in the South Dakota House and unanimously in the Senate; Gov. Kristi Noem signed the bill in March.

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Expunge? Seal? States re-examining laws that determine fate of conviction records for low-level marijuana possession offenses

In early October, President Biden signed an executive order pardoning about 6,500 individuals who were federally convicted of simple marijuana possession between 1992 and 2021. He also urged governors to follow suit by pardoning state-level marijuana possession convictions.

While all Midwestern states allow people to petition for such pardons, they diverge over what to do with possession conviction records.

Illinois’ 2019 legislation legalizing recreational marijuana (HB 1438) includes language to automatically expunge most past convictions, while Michigan lets people apply to have their records sealed. Under a 2020 law (HB 4980), Michigan will begin automatically sealing a limited number of certain convictions, but only after seven years.

Legislators and policymakers in other states remain uncertain, or unconvinced. In North Dakota, for example, the debate over how best to address low-level possession and related criminal records has evolved over the past four years.

A failed 2018 ballot initiative sought to not only legalize recreational cannabis, but also automatically expunge all nonviolent marijuana convictions within 30 days of passage (excluding sale-to-minor convictions).

Rep. Shannon Roers Jones, co-chair of the Midwestern Legislative Conference’s Criminal Justice & Public Safety Committee, says although she spoke out against the measure at the time, she found common ground with advocates regarding decriminalization and clemency.

In the 2019 legislative session, she sponsored two bills on that front.

The first, HB 1155, would have made possession of drug paraphernalia and up to an ounce of marijuana a noncriminal, fineable offense instead of a misdemeanor.

“My thought process is more on weighing the harm to the person of consuming marijuana versus the harm to that person of having a criminal record that impacts [his or her] ability to hold a job, to find housing, to join the military,” Roers Jones says.

HB 1155 didn’t advance, but parts of it became HB 1050, which was signed into law that year, making possession of less than half an ounce of marijuana a criminal infraction. Subsequent infractions within a year elevate the penalty to a misdemeanor.

Another of her bills (HB 1256) created a way for people to petition to seal records of nonviolent, non-sex-offense convictions if they have been in good standing for three years.

Courts were also given the ability to grant “certificates of rehabilitation” to which people can refer for criminal background checks.

“I think that’s maybe even more valuable than just having the record sealed, because we all know that if you do a Google search for somebody’s name, that information is still going to be out there,” she says.

In 2021, legislators passed HB 1196, allowing multiple eligible convictions to be sealed at once rather than just the most recent one.

And shortly following the passage of HB 1050, the state’s Pardon Advisory Board adopted a policy to allow people convicted specifically of low-level marijuana possession to apply for a pardon in a more simplified fashion. According to Roers Jones, as of fall 2022, 83 people had received such pardons. (Around 175,000 North Dakotans are eligible.)

Expungement vs. sealing

Requiring offenders to apply to seal a marijuana record is common in multiple states. Some advocates say a better process would include automatic and full expungement — the actual destruction of physical records instead of sealing them from public view.

“When they are sealed or set aside, there are certain circumstances under which those records are still available for review by either law enforcement or the court system, and in some cases third-party background check companies,” says Morgan Fox, political director for the National Organization for the Reform of Marijuana Laws.

Roers Jones says erasing all traces of a criminal offense is nearly impossible in a digital age, while full expungement could complicate high-level background checks such as for federal employment. Instituting an automatic expungement process would put undue burdens and costs on state court systems, she adds.

“If the burden for sealing those records goes back to the court and they miss something, does that create a liability to someone whose record they haven’t sealed?”

Michigan Rep. Graham Filler agrees.

In 2020, he led the passage of a package of bipartisan expungement-reform bills, one of which, HB 4982, allows individuals convicted of a marijuana misdemeanor offense to petition to have their conviction sealed. (Prior to legalization, possession of any amount of marijuana was a misdemeanor.)

After law enforcement input, legislators included a 60-day window for prosecutors to rebut the sealing of a person’s record.

“Law enforcement said, ‘Look, there are a couple of cases where an individual was clearly a high-level drug dealer. … For whatever reason, they pled down to use and possession for marijuana,” Filler says. “That’s really bad in a community when that individual is now going to automatically be able to wipe that away.”

Illinois’ law requires that all relevant records for previous possession arrests for up to 1.06 ounces (the current legal limit) be expunged by January 2025. For previous convictions of nonviolent possession charges, State Police had until mid-2020 to identify and share records with the Prisoner Review Board to evaluate for possible pardons. The board, before submitting its recommendations to the governor, informs county state’s attorneys and gives them 60 days to object. The attorney general then petitions courts to expunge the criminal records of those granted a pardon.

People convicted of possessing more than 1.06 ounces but less than 17.64 ounces can petition the courts to have their records expunged (with input from state county attorneys). Illinois Gov. JB Pritzker said in October that nearly 800,000 convictions had either been pardoned or expunged.

A federal issue

Some Midwestern governors reject President Biden’s suggestion. Nebraska Gov. Pete Ricketts and Attorney General Doug Petersen released a joint statement calling the policy “ill-advised.”

In his statement, Indiana Gov. Eric Holcomb said Biden should work to change federal law, “especially if he is requesting governors to overturn the work local prosecutors have done by simply enforcing the law.”

“Until these federal law changes occur, I can’t in good conscience consider issuing blanket pardons for all such offenders,” Holcomb said.

Fox says Biden’s action is a step in the right direction, but that Congress should extend federal pardons farther back than 1992, make people eligible for pardons regardless of immigration status, and completely de-list cannabis from the Controlled Substances Act. He also referenced federal legislation (HR 6129) that would award grants to states to help reduce the financial burden of expunging

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A look at how the 2022 election results will impact state policy and legislatures in the Midwest — in the year ahead and beyond

Term limits come to North Dakota, while Michigan voters OK a tweak to their law

North Dakota now has among the strictest laws on legislative term limits in the country. In November, more than 60 percent of voters in that state approved a constitutional amendment placing a lifetime cap on legislative service — eight years in the House and eight years in the Senate. With this change in North Dakota, all five Midwestern states that allow for citizen-initiated ballot measures now have term limits.

Three of these five states do not impose lifetime bans, however. Consecutive-only limits in Ohio and South Dakota allow legislators to bounce between the two legislative chambers and continue legislative service indefinitely, if they so choose and continue to be re-elected. (Nebraska has a consecutive ban as well, but it has a single-chamber legislature.)

North Dakota joins Michigan with a lifetime limit on legislative service.

In November, Michigan voters approved a legislatively referred constitutional amendment that retains, but modifies, that state’s term-limits law. Michigan’s lifetime cap remains in place, with a maximum of 12 years of legislative service instead of 14. However, all 12 of those years can now be spent in a single chamber. The previous law set limits of three two-year terms in the House and two four-year terms in the Senate. In part, legislators hope the tweak will allow for more legislative continuity and institutional knowledge in each chamber.

Also this year, North Dakota joined five other Midwestern states with term limits for governors. Each of these states imposes a cap of two four-year terms. North Dakota now joins Michigan with a lifetime cap on gubernatorial service; the four other states have consecutive-only limits.

Three legislative chambers flip, leading to partisan ‘trifectas’ in eight Midwestern states

Next year, one party will have full control of the state legislature and governor’s office in all but two Midwestern states, the exceptions being Kansas and Wisconsin.

This is because of a shift in the partisan balance of the Michigan and Minnesota legislatures. Republicans had enjoyed majority control of the Michigan House and Senate, but Democrats were able to “flip” both legislative chambers in November while Gov. Gretchen Whitmer won re-election. Minnesota had been one of the few U.S. states with a split legislature: one party controlling one legislative chamber each. Democrats now have a “trifecta.” They held control of the House and flipped partisan control of the Senate, while Minnesota Gov. Tim Walz won his re-election bid.

Over the next two years, Republicans will have full control of state legislatures and governor’s offices in Indiana, Iowa, North Dakota, Ohio and South Dakota. Along with Michigan and Minnesota, Democrats have a trifecta in Illinois. (Nebraska has a Republican governor and nonpartisan unicameral legislature, though a majority of legislators are Republican.)

One other noteworthy result from this year’s elections was the success of incumbent governors: In the Midwest, all eight seeking re-election won.

South Dakotans approve Medicaid expansion; policy now in place in nine Midwestern states

South Dakota will soon become the ninth state in the Midwest that expands its Medicaid program to cover more low-income adults. The ballot measure won the support in November of 56 percent of voters. Since passage of the Affordable Care Act, states have had the option of expanding the reach of this public health insurance program.

Most states have done so through legislative and gubernatorial action. However, South Dakota now joins Nebraska in having the expansion approved through a citizen-initiated ballot measure. Kansas and Wisconsin are the only states in the Midwest, and two of 11 nationally, that have not expanded Medicaid under the ACA, according to the Kaiser Family Foundation.

‘Rights’ amendments added to state constitutions in Michigan, Iowa and Illinois

Michigan is the first state in the Midwest with constitutional language that explicitly secures a right to an abortion. Fifty-seven percent of state voters approved Proposal 3 in November. In the Midwest, since the U.S. Supreme Court’s overturning of Roe v. Wade, other notable developments on this issue have included the Indiana General Assembly’s adoption of a ban on most abortions and Kansas voters’ rejection (in August) of a legislatively referred proposal which stated, in part, that the Kansas Constitution “does not create or secure a right to abortion.”

At least two other legislatively referred “rights” amendments appeared on state ballots in the Midwest this year:

In Iowa, voters added a “right to bear arms” in the state Constitution. Such provisions are common in U.S. state constitutions. The Iowa measure also adds new constitutional language that says any government restrictions on gun rights “shall be subject to strict scrutiny.”
Illinois is the first state in the Midwest to include constitutional language guaranteeing workers’ rights to collective bargaining and to bar legislative passage of so-called “right to work” laws.

Voters change laws on elections, bail (in Ohio) and minimum wage (in Nebraska)

In all, voters in eight Midwestern states decided the fate of 15 proposed constitutional amendments or statutes this November. Among the measures that passed:

The minimum wage in Nebraska will be gradually raised to $15 an hour by 2026, with automatic, annual cost-of-living increases in subsequent years. Also in Nebraska, all voters will be required to show photo identification before casting a ballot.
Changes in election law also are coming to Michigan. That state is constitutionally required to provide nine days of early, in-person voting. Additionally, voters can request an absentee ballot by mail for all future elections. When voting in person, an individual can verify his or her identity with a photo ID or a signed statement. The state also must ensure citizens’ access to absentee-ballot drop boxes, fund a ballot-tracking notification system, and pre-pay the postage for absentee applications and ballots.
The Ohio Constitution now includes language that restricts voting in state and local elections to a U.S. citizen who is at least 18 years old and who has been a legal resident and registered voter for at least 30 days. This was one of two legislatively referred constitutional amendments approved by Ohioans. A second measure requires judges to consider public safety when setting bail amounts.

The post A look at how the 2022 election results will impact state policy and legislatures in the Midwest — in the year ahead and beyond appeared first on CSG Midwest.