CHICAGO (AP) — An Illinois Democrat who has led work on implementing a key part of President Barack Obama's health care overhaul now says the state will need to partner with the federal government for its insurance exchange.
Rep. Frank Mautino told The Associated Press this week that Illinois won't meet be able to meet a Nov. 16 deadline for the online insurance marketplace and must consider a new option — a federal-state partnership — to get ready for its first year if the U.S. Supreme Court upholds the law.
That would put Obama's home state among a majority of states limping unsteadily toward implementing the law. The court is expected to rule on the reforms Thursday, and could overturn or dismantle the law, leaving states to determine how to proceed from there.
A spokeswoman for Gov. Pat Quinn said Illinois is prepared for the court's decision.
"We are prepared for the numerous scenarios," said Quinn spokeswoman Brooke Anderson. "We are making progress, and have since the law was passed, to implement the (Affordable Care Act) in Illinois."
Insurance exchanges, a cornerstone of Obama's health law, would allow people and small businesses to comparison shop online for insurance starting in 2014. The concept has been described as Travelocity for health insurance.
Before new federal rules issued in May, there were two choices for states: run your own exchange, or see the federal government step in and take over.
But as states lagged behind and asked for more flexibility, the federal government developed a third choice — a state-federal partnership — that will make it easier for slower states to catch up and provide political cover to state officials who don't want to be seen doing anything to hasten what critics have called "Obamacare."
Most people buying insurance through the exchanges will likely be eligible for taxpayer-financed subsidies, and the exchanges will help people who qualify enroll in Medicaid. Participating insurance plans would have to take all applicants, regardless of prior health problems, unless the Supreme Court strikes down that portion of the law along with a requirement that most people buy health insurance.
Illinois has received three federal grants totaling $39 million to study and start building an exchange, but the Legislature has failed to pass a law establishing it, a necessity. The Quinn administration has considered an executive order to establish one, but Mautino said it's too late now.
"Because of the timeline, the first year of the exchange is going to be a joint state-federal exchange," Mautino said.
If the law is overturned or altered substantially by the Supreme Court, Mautino said there will be questions, including what happens to the nearly 2,000 Illinois residents covered by a federally funded insurance plan for people denied insurance because of pre-existing conditions.
"On Thursday, I'll read the decision," Mautino said. On Friday, "I'll start making some phone calls."
The twin health care problems of rising insurance costs and people losing health coverage won't disappear if the court overturns Obama's health law. That scenario could leave Illinois Democrats and Republicans floating their own ideas for health care.
Sen. Heather Steans, a Chicago Democrat and sponsor of recent Medicaid legislation in Illinois, said the state "can still pursue universal coverage" if the law is overturned, using Massachusetts as a model.
