Illinois officials must decide how to implement key provisions of President Barack Obama's health care overhaul, including establishing an online insurance marketplace where people and small businesses can comparison-shop beginning in 2014, now that the U.S. Supreme Court upheld the law's requirement that almost every individual have insurance.
State Rep. Frank Mautino, who has led work on implementing the so-called insurance exchange, told The Associated Press this week that Illinois won't be able to meet a Nov. 16 deadline to get it set up, and will have to consider a federal-state partnership.
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Illinois has received three federal grants totaling $39 million to study and start building an exchange, but the Legislature failed to pass a law required to establish it, partly because many wanted to wait for the Supreme Court decision. Gov. Pat Quinn's administration has considered an executive order to establish one, but Mautino said it's too late now.
States have the option of running their own exchanges, but the federal government offered the possibility of a state-federal partnership that will make it easier for slower states to catch up. Insurance carrier lobbyists say Illinois has not given insurers enough information to get their health plans ready to sell on an exchange.
Quinn would not answer questions about Illinois' plans until an afternoon news conference, but aides said he was "thrilled" by the high court ruling.
Others weren't so happy. State Sen. Bill Brady, a Bloomington Republican who co-chaired a legislative study committee on the exchange, said the ruling "will have tragic consequences that will ... drive up health care costs and put yet another financial burden on our already struggling small businesses."
He said the state will look for ways to implement the law while "providing the greatest options and lowest cost for our families and businesses."
Republican U.S. Sen. Mark Kirk said the law threatens the country's economic recovery and said Congress should repeal it.
His Democratic counterpart, Sen. Dick Durbin said the ruling will enable the country to "address the unsustainable increase in health care costs" by expanding insurance coverage.
Several physician and health care organizations, including the Illinois Hospital Association, praised the court's decision. The association said expanding coverage and eliminating exclusions for pre-existing conditions and coverage caps means "people in Illinois will no longer have a diminished quality of life, be at risk of dying merely because they lack health insurance or be forced into bankruptcy because of a devastating diagnosis."
Illinois officials estimate about 800,000 now-uninsured residents would get public or private health insurance, including about 500,000 -- many childless adults -- who would become eligible for Medicaid under the expansion.
The health care law will require states to provide Medicaid coverage for adults with incomes of up to 133 percent of the federal poverty guidelines, but Illinois has been far more generous for parents and has taken steps to pare its Medicaid rolls.
At its peak, the Illinois Family Care program, a favorite of imprisoned former Gov. Rod Blagojevich, covered parents with incomes up to 400 percent of the federal poverty guidelines, or $60,500 for a two-person household.
After July 1, Illinois will only cover the neediest parents with household incomes up to 133 percent of federal poverty guidelines, or about $20,100 for a two-person family -- throwing more than 25,000 working parents out of the program as part of a $1.6 billion Medicaid spending cut that Quinn signed into law.