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Wednesday, September 12, 2012
State council considers required insurance benefits
By Jamey Dunn
Illinois officials are weighing choices that could determine the future of the insurance market in the state for the near future.
As part of the Affordable Care and Patient Protection Act, Gov. Pat Quinn’s Health Care Reform Implementation Council is working to determine a benchmark for benefits that insurance companies must offer to individuals and small businesses in Illinois.
“The benchmark will have an impact on insurance that’s sold both on and off the [online insurance] exchange,” Coleen Burns, special council for health policy for the Illinois Department of Insurance, said at a meeting of the council today.
The council will recommend one plan that will set the standard for benefits offered in 10 service categories, such as prescription drugs, maternity care and laboratory services. These basic required offerings are known as essential health benefits.
The council can choose between several existing plans, such as the three largest state employee health plans or the three largest group plans in the state. Once the council picks one plan to use as a model, other insurers must offer benefits under the 10 categories that are equal to the value of benefits offered in the plan. Illinois must pick a plan as is and cannot add on or subtract benefits. The standards set by the council will kick in in 2014 and last until 2016, when the federal government plans to reassess the required essential benefits.
Burns said the choice will set a floor for required benefits, but insurance companies can offer more generous plans. “A[n insurance] carrier is at liberty to sell a bronze plan, a silver plan and a platinum plan, but all three plans must meet the benchmark.”
The council is taking public comment and suggestions through September 19, and Quinn must make a recommendation to the federal government by September 30. If the state does not choose a benchmark plan, the feds will choose one for it.
Council members have to weigh several areas of interest when considering what essential benefit requirement to recommend.
Members of the committee said they hope to ensure that there are strong benefit levels for mental health and substance abuse treatment, which are two areas they say are often inadequately covered by insurance. “It truly signals that there is greater acceptance and understanding that the treatment of mental health disorders and substance abuse must be a priority,” said Lorrie Rickman Jones, director of the Department of Human Services' Division of Mental Health.
Russell Welcherd from Quincy asked that the council pay close attention to the benefits related to treating chronic disease. Welcherd has a genetic disorder that causes emphysema. He receives weekly treatments for his illness. “If a health insurance policy that discourages the proper treatment is imposed, people like me will ultimately suffer.” Welcherd said that without his treatment he would have to make frequent emergency room visits and be placed on oxygen therapy.
Larry Barry, president of the Illinois life Insurance Council, warned Quinn's council members that requiring plans to have overly generous benefits could make the insurance too pricey for many individuals and small businesses. “Now you’ve got a wonderful product, but it’s one that no one can afford.”
He also asked state officials to make their decisions in a timely manner and let insurers know what is expected of them, so they can change their offerings accordingly. “We, as the sellers of this product, aren’t going to be able to wait until the last minute.”
For more on the state’s implementation of the Affordable Care Act, see the current Illinois Issues.
To submit a comment to the implementation council, go to http://www2.illinois.gov/gov/healthcarereform/Pages/default.aspx
Presidential coattails less of a factor in state legislative races
By Jamey Dunn
While the presidential election has captured the nation’s attention, Illinois political scientists say that the shifting regional demographics and the state’s new electoral maps will have a much larger impact on down-ticket legislative races in Illinois than the candidates at the top of the ballot.
“[President Barack] Obama will carry Illinois comfortably,” said John Jackson, a visiting professor with the Paul Simon Public Policy Institute at the Southern Illinois University. The president won the state with about 62 percent of the vote in 2008. Recent polling suggests that his popularity in Illinois has slipped since but still shows him leading Republican challenger Mitt Romney by a strong margin.
Even many Illinois Republicans admit that it is likely Obama will win his home state in the upcoming general election. "Let's face it: If Mitt Romney would win Illinois, he'd win by a biblical landslide nationwide. But I think Mitt Romney is going to run much better in Illinois than John McCain ran because I don't think Barack Obama is going to do that well in Illinois," former Gov. Jim Edgar told reporters at the Republican National Convention.
Edgar said unpopular Democratic leaders such as Obama and Gov. Pat Quinn do not seem to be assets for Illinois Democrats running for state legislative seats.
“Where Obama’s numbers are not good downstate, and where Quinn’s numbers are not good, the Democrats are going to try to make the elections as local as possible,” said Kent Redfield, an emeritus professor of political science at the University of Illinois Springfield. “You’re going to see Democrats downstate running away from the national ticket, away from Gov. Quinn.”
In 2008, Obama carried 30 counties that previous Democratic presidential candidates John Kerry and Al Gore lost. Jackson — who looked at the 2008 results in his 2009 paper entitled, "The Anatomy of President Barack Obama’s General Election Victory in Illinois" — said it is likely that Obama will lose some of that ground this time around. He said an Obama win would likely look more like Quinn’s 2010 gubernatorial victory, with the president taking Democratic strongholds, such as Cook County and other northern counties. Jackson said Obama would also likely pick up a few downstate Democratic-leaning counties, such St. Clair County in the Metro East area near St. Louis.
Republicans predict a similar outcome. “I think you’re going to see a different election in Illinois, and I think you’re going to see a pretty good showing by Romney. Look, [Obama] is going to do very well in the city. We know that. But I don’t think you’re going to see the type of results in the collar counties and downstate that you saw the last time,” Illinois House Minority Leader Tom Cross said earlier this summer.
However, Jackson said that Romney is unlikely to give other Republican candidates much of a boost, either. “I think symbolically, the Republicans will run with Romney. I am not sure he will make that much difference.”
Jackson said Illinois Democrats are in danger of their base not feeling pressured to get to the polls because they feel that Obama will have no trouble winning the state. “The Democrats need to guard against that. The need to work pretty hard, not because of Obama but because of the other races [on the ticket].”
Jackson said that the so-called coattail effect of a presidential race is often overestimated in the lead up to the election. “The president rarely has much by way of coattails. I don’t expect strong coattails except on the issue of get-out-the vote drives.”
In his 2009 paper, Jackson wrote that Republican might have overestimated the power of Obama’s coattails in 2008. “The Republicans especially fretted publicly over a potential ‘coattail’ effect from the Obama campaign harming the down-ballot Republican candidates’ races. There were predictions of further Republican losses in the Illinois congressional delegation and in the Illinois House and Senate because of the feared Obama electoral tide. Most of that fear proved to be unfounded or at least exaggerated in the end.”
Redfield said that the new legislative districts, which were drawn by Democrats, and changes in demographics will play a much larger role in state legislative races.
However, he pointed out that the general election is still a ways off, and the presidential race could end up being more of a factor than expected. “Clearly, we don’t know what things are going to look like two months from now,” he said. “If it’s highly competitive, or even if Romney is pulling ahead [nationally], that’s going to generate enthusiasm.”
Redfield said Democrats drew districts with an eye toward protecting the downstate incumbents while carving out new districts in the suburbs. “I think the map is defensive downstate and aggressive in the suburbs.”
He added: “You could end up with a Democratic majority in the House and the Senate with a smaller percentage of downstate members in the caucus. In fact, I think that’s likely that there will be fewer downstate Democrats after this race.”
Redfield said downstate Democrats face tough races, and when they do leave their seats, be it through losses at the polls or retirement, voters would likely replace some of them with Republicans. “Downstate is a problem for Democrats. I mean, there’s absolutely no questions about that.”
He said the potential for fewer downstate Democrats and fewer suburban Republicans could lead to more regional conflicts in the future. “Any time Chicago and the suburbs agree on an issue, downstate [would be] in trouble.”
Jackson said his biggest concern about the results of the presidential election is whether the winner can be effective. If Obama wins, he faces the possibility of pitching his policy ideas to a Republican majority in the U.S. House and maybe a Republican-controlled Senate. Jackson predicts that the national struggle for control of the U.S. Senate will be a nail biter. “I think that is the question. I think it’s so close in so many of the races it kind of depends on who’s got the best ground game.” If Romney wins, he could face a Democrat-controlled Senate. Or if Republicans gain a slim majority in the Senate, they may get a taste of their own medicine if Democrats use the same procedural moves that Republicans have during Obama’s first term to freeze big votes in the chamber.
Jackson says he is “cautiously pessimistic” about the potential for either candidate to achieve much in the way of policy changes after he is sworn in. “I’m looking for gridlock being the most likely outcome again.”
Tuesday, September 11, 2012
Sunday, September 09, 2012
"The Unions Own Us" Starring: The Insiders
Above: John Sullivan, John Spring, The Dick and a couple union dudes, one of which is now the chairman of the Adams County Democrat Party
Check here to see how much Sullivan gets from the unions both public and private. It will help explain why Illinois will never see any meaningful pension reform as long as Sullivan and his Chicago Democrat insider pals are in charge.
Read more...
For the few of you who still read the QHW, remember this
You can expect to see very favorable coverage of John Sullivan from the local dead tree media (see top right column above list of host committee for Sullivan fundraiser featuring outsider John Cullerton ).
Above: Insiders Gov Quinn, John Spring and John Sullivan unveil highway named after local newspaper publisher
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