Top Ten Things You Should Know About lllinois Health Care Reform

On February 7, 2011, Governor Quinn's Illinois Health Care Reform Implementation Council held a public hearing to release its initial recommendations on the implementation of the Affordable Care Act in Illinois. The recommendations, which include issues that the state must address immediately and decisions that will be made after the Council gathers more information from stakeholders and the federal government, were offered to the public to review and comment; however, the recommendations will be fine-tuned before final recommendations are presented to the Governor.

The report is a fairly short 19 pages and easy to read, but if you want the "Cliffs notes" version, here are the top 10 main take-aways from the meeting:

1. The Council recommends that Illinois (rather than the federal government) create a state based Health Benefits Exchange, which is the centralized marketplace that in 2014 will provide individuals and small businesses with access to more affordable, comprehensive health insurance coverage options.
2. The Council recommends that the Exchange should be run by a quasi-governmental entity led by an appointed board of directors. This administrative structure is similar to the Illinois Comprehensive Health Insurance Plan Board and the Office of Health Information Technology.
   
3. The Council does not recommend a preferred way to finance the administration of the Exchange at this time although it specifies that funding should not come from the state general revenue funds. The Council is still considering an assessment on insurance companies, providers and others who will benefit from broader health insurance coverage, as possibilities for revenue sources.
4. The best current estimate of the number of uninsured in Illinois is about 1.5 million. Of these, the Council estimates that in 2014, between 500,000-800,000 people will be added to Medicaid, between 200,000 and 300,000 people will purchase subsidized coverage through the Exchange and between 300,000-600,000 people will remain uninsured. Another 1 million Illinoisans who are currently insured will get private insurance through the Exchange, much of it with some subsidy. Unlike in the past, Medicaid and private insurance will be merged into one centralized marketplace.
5. The Council recommends that the state continue to engage employers, consumers and insurers, because successful implementation of the Exchange will necessitate a strong outreach and education component, including working with community-based Navigators and insurance brokers.
   
6. The Council recommends that the state take all available avenues to review and control rate increases in the insurance premium market as soon as possible. Additional information can be found on the Illinois Department of Insurance website.
   
7. The Council recommends convening a Healthcare Workforce work group to develop an aggressive, comprehensive plan to professional and paraprofessional healthcare and public health worker shortages statewide, now and in the future.
   
8. The Illinois Health Information Exchange (HIE) strategic and operational plan was approved by the federal government in December 2010. It focuses on the adoption and meaningful use of electronic health records; ensuring that providers who wish to begin exchanging health information electronically in 2011 can do so; developing an all payer claims database and other priorities which can be found here.
   
9. The Council recommends waiting for further guidance from HHS before deciding whether to require benefits beyond the “essential benefits” defined by HHS.
   
10. The Council does not recommend early implementation of Medicaid expansion in Illinois (i.e., beginning to enroll people under 133% FPL before 2014) but remains open to considering changing the moratorium on new expansions if a financially advantageous opportunity for the State arises.

Stephanie Altman
Health & Disability Advocates