Illinois still has no plan to run its own health insurance exchange

By Meredith Colias

A plan for Illinois to run its own health care exchange beginning in 2015 stalled again as the House adjourned its spring session without finalizing legislation to adopt it.

The Affordable Care Act will require individuals to obtain health insurance beginning in January 2014 or face a tax penalty. An exchange would include an online marketplace to help uninsured individuals find insurance plans they could afford or determine if they would be Medicaid-eligible. Illinois’ exchange will be run by the federal government its first year.

“The plan for 2014 is unchanged,” Peoria Democrat Sen. David Koehler said. “Our hopes were to pass the bill and to be able to set up a state-based exchange by 2015. We’ll continue to work on it.”

In a statement, a spokesman for Gov. Pat Quinn said his administration is looking forward to the legislature’s fall veto session for the next opportunity to move forward on the state’s takeover of the exchange.

“I can’t really call [Illinois] behind because [other] states are making their own choices on whether they are going to run the exchange,” said Alan Weil, executive director for National Academy for State Health Policy. “From a formal sense, it’s not too late to do it in ’15 if  the legislature came back and changed their mind. Of course, there is no reason to think they would.”

If Illinois allows the federal government to continue to run the exchange past its first year, there are concerns that the state would be giving up an opportunity to tailor some of the rules to make sure areas such as rural downstate Illinois see enough competition between providers.

Koehler has said he believes only smaller portions of the bill might be changed. Negotiations are continuing through the summer. “All parties have agreed that a state-run exchange is probably in the best interest of all of us,” Koehler said.

One notable exception is House Speaker Michael Madigan.

“It’s primarily the speaker’s fear that things are not going to go well with this, and we ought to just leave it as a federal exchange.” Koehler said. “I have not talked to him directly.”

Madigan spokesman Steve Brown told the Associated Press there was concern that the bill did not have bipartisan support to pass the House, where Democrats hold a 71 to 47 majority over Republicans. The Democrat-controlled Senate passed its version along strict party lines in May.

Willow Hill Republican Rep. David Reis said Democrats could pass the legislation if they wanted. “This is their issue. They need to put the votes on it if they want to pass it.”

Reis, the minority spokesman for the House Insurance Committtee, said many Republicans felt the issue was deeply unpopular, and there was a lot of “anxiety” with how the legislation will be implemented, including how the state will pay the costs to run the exchange into the future.

Since the House did not take up the Senate version of the bill, “maybe that’s just their avenue of saying, ‘Maybe we need to step back and look at this,’” he said.

See House Bill 3227 here.