The confusing world of health insurance could get a lot easier for Illinoisans in October, when the federal government opens a public health insurance marketplace here. The state would only get to take control of the marketplace, however, after creating a board to oversee it. The Illinois Senate approved a bill to do just that last week, putting the state one step closer to implementing the federal health care reforms of 2010.
Often referred to as “Obamacare,” the federal Patient Protection and Affordable Care Act of 2010 was a set of sweeping changes to health insurance in the United States. It requires almost everyone to have health insurance in an effort to lower health care costs. To meet that goal, states are supposed to create public “exchanges” where people can learn about, compare prices and purchase private health insurance plans that meet basic standards.
Illinois is one of seven states currently slated to partner with the federal government for the state exchange, meaning the U.S. Department of Health and Human Services will make most of the decisions for Illinois’ exchange. Seventeen other states plan to open their own state-run exchanges, while the remaining 26 states have opted out and will default to a federally run exchange.
The bill passed by the Illinois Senate last week would allow Illinois to take control of its own exchange by creating a governing board that oversees the exchange. Previous attempts to pass similar bills were complicated by disagreement over whether insurance companies would be represented on the board. Insurers said they would bring valuable knowledge to the board, while health care advocates said the insurers would invariably try to undercut the standards to which plans in the exchange are held.
Jim Duffet, executive director of the Illinois-based Campaign for Better Health care, said the bill represents three victories for health care advocates. The first is that the bill allows for a racially, geographically and culturally diverse governing board, he said, adding that no more than four members of the 11-member board can represent insurers, health care administrators or health care professionals.
“This bill makes sure that the board won’t be a rubber stamp for the insurance industry,” Duffet said. “We’ll keep fighting to make sure Governor Quinn doesn’t appoint any insurance representatives to the board.”
Funding for the exchange will come from insurers, not consumers, Duffet said. Additionally, the governing board will have the power to hold public hearings, conduct studies and recommend legislation.
But Duffet said one thing is missing from the bill: forcing insurers to justify rate increases to regulators. His group and others plan to continue pushing for that as well.
The bill, House Bill 3227, passed the Senate with a vote of 37-19. It now must go back to the House for approval because of changes made by the Senate. The House has until May 31 to pass the bill.
Gov. Pat Quinn praised the Senate’s passage of the bill last week.
“This legislation is an important first step towards my agenda to ensure Illinois fully reaps the benefits of the Affordable Care Act,” Quinn said.
Last week, California’s health exchange, known as Covered California, offered the nation’s first glimpse of prices on a state-based exchange. Predictions of “rate shock” – huge rate increases due to the federal reforms – didn’t materialize, with the average price for a mid-level plan coming to $321 per month. The plans included in the exchange will cover patients visiting 80 percent of that state’s doctors and hospitals.
In the same week, however, two of the nation’s largest health insurers announced they wouldn’t participate in California’s exchange. If too many companies decide not to participate, the effectiveness of the exchanges could suffer.
Duffet said he wasn’t worried that a similar situation arising in Illinois could negatively affect this state’s exchange, adding that the exchange has six companies which will offer a combined total of 165 plans. By comparison, California’s exchange has only 13 plans.
Contact Patrick Yeagle at email@example.com.
For a map of states with health insurance exchanges, visit http://tinyurl.com/State-Exchange-Map