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 "We want people to be able to log on, type in their information, be
told, 'This is what you qualify for,' and then be able to buy it,"
said state Rep. Frank Mautino, D-Spring Valley.
Mautino introduced legislation last week that would create the
online marketplace with a governing board and framework to pay for
the exchange.
Each state must have a fully operational health insurance exchange
by 2014, according to the federal Patient Protection and Affordable
Care Act. However, the law requires Illinois lawmakers to create an
exchange by June 2012, so the state can test the exchange model by
2013.
If Illinois does not meet the 2012 deadline, the federal government
will impose its own insurance exchange on the state.
Mautino, who heads the legislative committee charged with creating
the exchange, said he intends to present his proposal to lawmakers
during the second week of the veto session. He admits the state
could vote on the exchange in the spring, but Mautino said he wants
a vote as soon as possible "to be that much farther ahead."
"We need to have a governing board, a list of their duties and a way
to pay for the exchanges in place before next spring," Mautino said.
"That way we can apply for federal money to build the exchanges."
Who pays?
The central question now facing Illinois lawmakers is who will pay
to run the health insurance exchange after 2014.
The federal government only is providing millions in one-time,
use-it-or-lose-it grant money to set up the high-tech electronic
insurance exchange.
A study released in September by the Boston-based consulting firm
the Wakely Group estimates Illinois' yearly operation costs
somewhere between $57 million and $89 million.
Mautino's legislation would impose an assessment, or a dedicated use
fee, on insurers to pay for the online marketplace.
He based his proposed exchange on Illinois' Comprehensive Health
Insurance Program, or CHIP, a pool of insurance plans for children
from low-income families.
"We're talking about an assessment (for CHIP) that's anywhere
between $75 million and $55 million last year," said Mautino.
Jim Duffett, executive director for the health care advocate The
Illinois Campaign for Better Health Care, said, "We do not think
($89 million) should be paid for by the people who will use this
exchange."
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But others balk at the idea that Illinois' insurance exchange should
cost nearly $90 million.
"I think it's ridiculous to spend that much," said state Sen. Bill
Brady, R-Bloomington. "We still don't know what the federal
government is going to require. To do anything before the Supreme
Court decision is premature."
The U.S. Supreme Court is expected to hear cases this session
challenging the constitutionality of the federal health care law's
individual mandate. Costs
In addition to the up to $89 million yearly operating price tag, the
Wakely report breaks down what an exchange would cost people who
seek insurance through the new marketplace.
The report details a per-person, per-month cost between $9 and $13,
with 486,000 people expected to enroll in the health care exchange
in 2014 and 1 million by 2016.
Duffett is quick to say the number of enrollees could be higher.
"Right now there are 1.7 million people in Illinois without
insurance," Duffett added "This exchange is expected to serve 1.4
million of those uninsured people."
Illinois' Medicaid population, currently 1.8 million people, Duffett
said, is also expected to drift in and out of the exchange.
In addition to meeting federal deadlines, Illinois is rushing to
secure federal dollars.
Mautino said $59 million for implementation of the exchange and
another $94 million for computer and technology infrastructure will
be made available in March.
The $94 million is earmarked, both by Illinois lawmakers and the
federal government, for technology to create a health insurance
exchange.
Mike Claffey, spokesman for the Illinois Department of Health Care
and Family Services, said the agency's computers "date to the 1970s
and are very antiquated."
[Illinois
Statehouse News; By BENJAMIN YOUNT]
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