 Illinois wants to have an exchange ready for federal review by 2013,
said Kate Gross, assistant director for health planning at the
Illinois Department of Insurance. If Illinois fails to set up its
exchange by January 2014, it will be required to use an exchange
chosen by federal officials.The $5 million, Gross said, will be
spent "on groups of consultants or firms to ... begin to help (us)
truly figure out all of the pieces that we're building."
These consultants or firms will write a report for lawmakers that
details how the state should proceed to create a health care
exchange, Gross said.
A handful of full-time state employees in the Department of
Insurance also are working on the exchange project, but Gross said
more outside help is needed.
Illinois has spent $1 million on consultants to study Illinois'
health insurance needs, but Gross said the state needed additional
consultants to discern where to begin.
That report, provided by Wakely Consulting Group, a private
consulting group from Boston, suggests broad goals, such as using
technology to identify underinsured populations and foster a
competitive health insurance marketplace.
But the report does not suggest how the state can accomplish
these goals. Lawmakers are going to have to decide how to follow up
on the report's vague goals.
The health insurance exchanges under the federal Patient
Protection and Affordable Care Act are intended to help consumers
shop for coverage in the same way airline travelers look for airfare
bargains online.
"An exchange is a store to purchase health insurance," Gross
said. "It will have a lot of encounters with people that will have
to be addressed. It will have a policy shop, it has to have finance
people, it has to have lawyers and actuaries. But it doesn't have to
have hundreds of those people."
Gross said the consultant or firm paid $5 million must address
whether Illinois' health care exchange will be part of state
government, quasi-public or nonprofit.
"How (the exchange) operates, its legal structure, its reporting
structure, how it's governed, how it's permitted to make decisions,
the amount of accountability to the people of Illinois -- all of
that is what the legislative study committee is charged with
studying," Gross said.
The Legislative Commission on Government Forecasting and
Accountability had its first study committee meeting Wednesday
morning in Chicago. The lawmakers discussed a number of topics but
did not arrive at any solutions. The commission is expected to meet
next week in Springfield.
Legislation signed by Gov. Pat Quinn in July started Illinois
toward the health care exchanges.
Senate Bill 1555 requires businesses with less than 50 employees
to spend at least $2,750 per employee on health insurance for their
workers. The legislation also sets an October 2013 deadline but does
not specify how the exchanges will be governed.
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Until a health care exchange is finalized and up and running,
Jamie Lewis is not going to worry. Lewis and her husband, Troy, own
Heritage Landscape and Design in Moline.
"You never know what's going to happen until it gets put
through," said Lewis.
Lewis said her firm, which employs about 26 people for landscape
design and hardscape work, pays for about half of the health
insurance bill for its workers, but she did not specify the actual
amount.
If the health care exchange doesn't deliver cheaper alternatives,
Lewis said, "we'll just hire less people," but she won't be laying
off any people.
Kim Clarke Maisch, the Illinois director for the National
Federation of Independent Business, or NFIB, which lobbies and
advocates for small- and medium-sized businesses, said those kinds
of decisions are what she hopes lawmakers keep in mind as they craft
Illinois' health care exchange.
"Who gets to be part of the exchange? Are employers going to have
to pay for part-time workers?" Maisch said. "There's a lot of
technical things, but very important aspects to the exchange, that
will make it or break it."
Maisch said she and her group are not opposed to health care
exchanges. But some private groups, including NFIB, and several
states -- not Illinois -- have filed a lawsuit against the federal
government over the requirement that people buy insurance. Opponents
of the law say it's unconstitutional for the government to force
someone to buy health insurance.
A federal court in Atlanta earlier this month ruled that the
mandate went beyond Congress' power. The ruling is the second on the
federal health care law. The first upheld the mandate.
Costs for the exchanges are likely to vary from state to state,
depending on how they build their exchanges.
[Illinois
Statehouse News; By BENJAMIN YOUNT]
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