Illinois Could Create Its Own State Health Exchange

Illinois may soon take on the responsibility of running its own healthcare marketplace under the Affordable Care Act. The General Assembly is working against a New Year's deadline to create its own exchange, or risk losing millions of dollars from the federal government.

When the Affordable Care Act went into effect last year, Illinoisans began signing up for healthcare in a marketplace technically run by the federal government. While other states opted to create their own exchanges, Illinois did not ... mostly in an effort to avoid extra costs.

217,000 people in Illinois have enrolled in plans under the Affordablee Care Act so far, but they may be in jeopardy if Illinois doesn't create a state-based exchange. A lawsuit in front of the U.S. Supreme Court has the power to take away federal subsidies from people in states without their own marketplaces.

Larry Singer, a professor of health law at Loyola University in Chicago, warns this could be bad news for those who wouldn't be able to afford health insurance without subsidies.

"They're going to be making some very difficult choices, potentially between medicine and educational expenditures and insurance coverage," he said.

Some of those people could be eligible for Medicaid, which Illinois expanded under the ACA, but not everyone will qualify.

The plan faces Republican opposition, not just because it's about Illinois' role in the Affordable Care Act, but because the decision comes a month before Republican governor-elect Bruce Rauner is sworn in.

Rep. David Leitch (R-Peoria) says the rush to create a state exchange goes against voters' wishes.

"Why are we moving now?" he said. "I see no reason at all why we should be moving this forward at this point when the people spoke and we have a new administration."

But Rep. Robyn Gabel (D-Evanston) says it's not just the lawsuit creating pressure to create a state exchange. It's the deadline from the federal government to create an exchange by the New Year, or forfeit $270 million in federal startup funds.

Gabel says the creation of the exchange wouldn't really make much of a difference to Illinois in the long run.

"This idea that there are extra taxes on the people of the state of Illinois if we have a state exchange versus a federal exchange is simply not true," she said. "Those taxes on the individual mandate and businesses are there regardless."

After federal money dries up, Gabel says the exchange will cost the state about $50 million to run every year, which will be paid for by fees. Gabel says the state's outreach effort, Get Covered Illinois, may have to cut down on marketing in order to slim down budgets.

Wednesday is the last day the General Assembly is scheduled to meet for the rest of the year, creating yet another deadline for lawmakers.