Governor Rauner’s Proposed Budget Could Shortchange

Governor Rauner’s Proposed Budget Could Shortchange
$1.1 Million in Vital Services for Howard Brown Health Center Clients

Media Contact: Kellee Terrell

March 18, 2015—Illinois Governor Bruce Rauner’s proposal to reduce state spending by $4.2 billion in FY2016 could result in severe and destabilizing service reductions for Howard Brown Health Center (HBHC) patients and clients, a new internal analysis shows.

HBHC’s system of medical, behavioral, wellness and preventative care, which serves more than 27,000 people annually, would face an estimated $1.1 million in service reductions if the Illinois General Assembly were to enact the governor’s budget.  More than 1,500 HBHC patients would be adversely affected by a delay or loss in medical care, housing or support services.

“Massive service reductions would have grave consequences for the entire community and especially low-income and disabled Illinoisans,” said Howard Brown Health Center President and CEO David Ernesto Munar.  “For low-income LGBTQ people, the loss of culturally competent care would make them particularly vulnerable to health disparities.

“Substantial cuts to Medicaid, breast and cervical care screening services and the Illinois AIDS Drug Assistance Program (ADAP) could disrupt services, leading to late testing, late diagnosis and worse health outcomes, which will actually increase state spending rather than reduce it,” Munar said.

HBHC’s impact analysis illuminates how proposed funding reductions would affect its patients and clients:


Medicaid, health insurance for low-income individuals, could see an overall funding reduction of $1.47 billion if the governor’s proposal is enacted.  Currently, these cuts threaten 1,072 HBHC patients who depend on Medicaid for their health coverage.

HBHC estimates that 79 or more patients could experience a substantial loss or delay in Medicaid coverage as a result of more stringent eligibility and recertification requirements called for in the governor’s budget proposal. HBHC projects Medicaid benefits for its patients would be reduced by as much as $553,500.

These cuts could also impact:

  • Eligibility: The proposed budget threatens to make it more difficult for low-income people to be eligible and recertified for Medicaid coverage, leaving more patients uninsured. 
  • Patient Navigation: Funding is at risk for staff positions assisting low-income clients in linking to specialty care and other services.  Moreover, across-the-board service reductions will mean HBHC staff will need to devote additional time and effort assisting patients in identifying available service referrals to meet their health and wellness needs. HBHC estimates increased care coordination costs of at least $150,000 annually to assist affected patients.
  • Benefits and Referrals: The size and scale of Medicaid and other social service cuts will have a direct and adverse impact on patients, including limiting access to dental health, supportive housing, behavioral health, services, public transportation, and other resources. 
  • Provider Capacity: Cuts to Medicaid rates will lead fewer health care providers to accept Medicaid, making it difficult for low-income and patients with disabilities to access care. 


Gov. Rauner has also proposed a nearly 25% reduction to AIDS services, slashing $6 million from the 2015 $26 million HIV/AIDS budget. The AIDS Drug Assistance Program, which is housed in this budget, could be greatly affected, impacting low-income Illinois residents who rely on ADAP to remain on life-saving treatment. HBHC estimates that 130 patients who receive ADAP benefits could lose $156,000 in services.

In addition to ADAP, proposed HIV prevention cuts could result in $100,000 less from state and city resources for HBHC’s Chicagoland HIV testing initiatives.  Almost 1,000 LGBTQ individuals and allies, including disproportionately affected communities of color, depend on HBHC’s Outreach Program for free rapid HIV and STI testing and critical prevention education services.

Deep funding reductions to ADAP and HIV prevention programs will not only affect the most vulnerable patients, but will also fuel HIV transmission in our state.

A recent study conducted by the Centers for Disease Control and Prevention found that more than 90% of newly diagnosed HIV cases could have been prevented by diagnosing people living with HIV/AIDS and ensuring they are immediately linked into medical care.  Access to reliable HIV testing and treatment services helps keep patients virally suppressed, which reduces new HIV infections among the community.


The Illinois Breast and Cervical Cancer Program (IBCCP) ensures that low-income uninsured women and transgender individuals have access to life-saving Pap smears, HPV testing and breast/chest health screenings.  The administration proposes to cut nearly $10 million from the program’s FY2016 budget. We estimate that this 71% reduction would slash $46,150 from the $65,000 awarded to HBHC each year. As a result, 152 of 214 IBCCP clients would no longer have access to program, which is particularly worrisome given that 62% of IBCCP patients had abnormal breast or cervical test findings from their screenings they received at HBHC.

Early detection for both cervical and breast cancer can the mean the difference between life and death and dramatic cuts to the IBCCP program will lead to more low-income and uninsured women and transgender individuals being diagnosed late with advanced cancer and with fewer treatment options. 


In addition, Rauner has proposed cutting $135 million in income tax revenue from the City of Chicago, which can affect the allocation of grants to organizations across the city.

These cuts could affect numerous city grants that HBHC’s Broadway Youth Center (BYC) depends on each year to assist homeless and LGBTQ youth. Such a cut could further disrupt the lives of nearly 550 homeless and unstably housed young people that access BYC drop-in services each year and who have nowhere else to turn for support. Hundreds of other clients who look to the BYC for GED certification, HIV/STI testing, behavioral health counseling and referrals for housing and shelter, could also lose essential services. 


“As we anxiously wait for the Illinois State Legislature to weigh in on Gov. Rauner’s proposed budget cuts, Howard Brown Health Center will continue to be a strong force, educating our community about the potential dangers to their health and to their lives of shortchanging our patients $1.1 million,” Munar said.

“It’s important for every one of us to be heard in expressing our concerns with these proposed budget cuts, which have the potential of seriously endangering the health of our patients and placing great strain on our agency,” says Magda Houlberg MD, HBHC’s Chief Clinical Officer.


About Howard Brown Health Center
Founded in 1974, Howard Brown Health Center (HBHC) is a Chicago-based health care and research organization, primarily serving the lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) community and its allies. HBHC serves more than 27,000 adults and youth each year. A patient-centered health home, HBHC provides primary medical care, behavioral health services, specialty chronic and infectious disease services, and conducts community-based clinical and behavioral research.

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