A Senate bill to create a state-run health insurance exchange died in the Illinois House as Speaker Mike Madigan failed to call it for a vote by the close of spring session. A Madigan spokesman explained that there was little bipartisan support for the bill and that Democratic House sponsors did not push hard for the bill to be brought to the floor.
“The political spin that we were hearing was, of course, lack of bipartisan support…which is bogus, because we knew there wasn’t going to be any anyway,” said Jim Duffett, executive director of the Campaign for Better Health Care, a grassroots coalition of more than 300 local and statewide organizations that works for accessible, affordable, quality health care for all. “Another statement that was also in the paper was that the House sponsors didn’t push hard to get the bill called. That’s a lie. They definitely did, and they communicated directly with the higher-ups that they wanted this bill to move forward.”
Duffett says he blames Madigan for burying the bill in the Rules Committee. He says the speaker has been dragging his feet on the implementation of the Affordable Care Act from the beginning.
Health Insurance Exchanges are part of the Affordable Care Act and are to be established and operational by Oct. 1, 2013. The exchanges, now being referred to as “marketplaces,” will be online Web sites where individuals and small businesses can go to shop for and compare health insurance policies. The successful enactment of the exchanges is a key milestone as the ACA mandates that individuals have insurance by Jan. 1, 2014 or face penalties.
According to Duffett, by failing to create a state-run exchange, Illinois falls into a hybrid category of a state/federal exchange, with the U.S. Dept. of Health and Human Services taking the lead on creating the exchange but the state having some involvement.
“Folks in Illinois will still be able to get into the state/federal marketplace,” Duffett said, “so they’ll still get access to insurance, but the state will lose the ability to make things even better for small businesses and individuals. A state marketplace might still happen in 2015, but people should be complaining to their state reps and state senators, asking why they didn’t take action.”
Brian Imus, state director for the Illinois Public Interest Research Group, a consumer group that works to protect public health and safety, financial security and participation in democracy, says that while Illinois residents will still have access to an exchange, the state-federal hybrid will not be nearly as beneficial as the state-run version would have been.
“Who gets to sit on the board of directors and make decisions about how the health insurance exchange operates is really important,” Imus said. “Will it be insurance company executives who have an interest in how it operates, or is it going to be consumers and small businesses who are actually the ones who are intended to be the beneficiaries of a program like this?”
Imus says the most immediate and important item on the agenda now is getting the word out about the Affordable Care Act, the need to buy insurance and that there will be an online marketplace where people will be able to shop for it on Oct. 1.
This marketing issue might be a bigger problem than one might think. A Kaiser Family Foundation Health Tracking poll in April found that 42 percent of Americans didn’t know that the Affordable Care Act is law. Seven percent of Americans think the Supreme Court overturned the ACA; an additional 12 percent think Congress repealed it.
Armed with a $28 million federal grant, the Illinois Dept. of Insurance will be running advertising in July to spread the word. Advocates say that the more people who enroll, the more affordable health insurance will be.
The IDOI and consulting firm Deloitte have set a goal of adding 782,446 Illinois residents to the insurance roles for 2014. State officials are projecting that number will increase to 1.9 million by 2020.
Illinois State Senator David Koehler, (D-Peoria), primary sponsor of the Senate bill to create a state-based exchange, says he suspected his bill was going to run into problems in the House but that he’s not ready to give up the fight yet. Koehler says he will work to try to develop more House support over the summer with a focus on bringing the bill back for a vote in the fall veto session.
“Whether you’re a consumer, a part of the insurance industry or a healthcare provider,” Koehler said, “I think everyone has a common interest that we should have our own Illinois state-based exchange. I think the issue is whether we should have a state-based exchange or whether we should just let the feds to it. Personally, I think we’d be much better served if we had a state-based exchange.”
Duffett says his organization is not giving up either.
“We’re going to be regrouping and we’re going to be pushing it in the fall veto session,” Duffett said, “but we shall see what happens. If nothing happens, it’s probably going to be a good five years before there’ll be serious traction to move the state toward a state-based exchange. And that will be very unfortunate, because we won’t have the ability to honestly have a debate about what the rates are going to be within the marketplace. The only way that small businesses and individuals are going to be able to fight the rates,” he added, “is if we have some type of a state-based marketplace.”