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Illinois health insurance

Percent of IL uninsured fell after first enrollment period

What’s your impression of the quality of life enjoyed in the “Land of Lincoln?” Chances are, the health status of residents and the state’s approach to health care reform factor into your opinion.

This brief summary looks at Illinois’ standing in several rankings of health care measures and its decisions related to the Affordable Care Act.

Illinois health ratings

Illinois saw its ranking improve in the 2014 Scorecard on State Health System Performance, moving up to 26th from 35th in 2009. The scorecard ranks the 50 states, and the District of Columbia, on more than 40 individual health measures to come up with an overall score. See the Illinois Scorecard to see how the state scored on each measure.

America’s Health Rankings places Illinois in the No. 30 spot in its 2013 evaluation, which is the most recent available. Illinois improved from its No. 34 spot in the 2012 report. The state earned high marks for good access to primary care doctors and dentists, low rate of drug deaths, and a low number of poor mental health days per month. Illinois is challenged by a high rate of binge drinking, high levels of air pollution, and a large disparity in health outcomes by the level of completed education.

The 2014 edition of Trust for America’s Health also tracks numerous public health measures. See Key Health Data About Illinois.

Finally, see health variations by county with data from the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin.

Illinois and the Affordable Care Act

In the 2010 vote on the Affordable Care Act, Sen. Roland Burris and Sen. Dick Durbin both voted “yes.” Durbin remains in office. Burris was appointed to the Senate by then-Gov. Rod Blagojevich to fill the seat vacated by Barack Obama. Burris was surrounded by controversy as Blagojevich was later convicted of corruption charges and sentenced to 14 years in prison, in part for soliciting bribes to fill the Senate seat. Burris was not charged with wrongdoing.

Burris, a Democrat, was replaced by Republican Mark Kirk. Kirk opposes the Affordable Care Act and has repeatedly voted to repeal the law.

Illinois’ delegation to the U.S. House of Representatives voted 11-8 in favor of the ACA.

At the state level, the governor’s office and both legislative houses are under Democratic control. Gov. Pat Quinn considered establishing a state-run health insurance exchange by executive order, but the state ultimately implemented partnership exchange.

Quinn lost his 2014 re-election bid to Republican Bruce Rauner. Medicaid expansion was a campaign issue, with Rauner saying he would not have authorized Medicaid expansion, but will not try to reverse the state’s position. The overall ACA was not frequently mentioned during the campaign. However, in one debate Rauner called the ACA a “financial disaster” for Illinois and said “We’ve got to step back key elements of” the law.

How the ACA is helping Illinois residents

According to the Kaiser Family Foundation, about 1.8 million Illinois residents are uninsured. Through the ACA, about 67 percent of the uninsured, nonelderly people in the state now qualify for financial assistance to help them gain coverage through either Medicaid or the health insurance marketplace.

The uninsured rate in Illinois decreased from 15.5 percent in 2013 to 12.3 percent after the 2014 open enrollment period. Nationally, the uninsured rate is 13.4 percent as of mid-2014.

Illinois enrollment in QHPs

About 23 percent of the estimated Illinois market – about 217,500 people – signed up for a qualified health plan (QHP) during the 2014 open enrollment period. Seventy-seven percent of those enrolling in a QHP qualified for premium subsidies.

Competition is expanding on the Illinois marketplace for 2015. Ten insurers will offer 410 plans for 2015 coverage. That’s up from six insurers and 165 plans in 2014. Average rate increases for 2015 are moderate, with the average increase highest for bronze plans and lowest for silver plans. Silver plans were the most popular option for 2014 in Illinois and nationally.

Medicaid and CHIP in Illinois

With the state’s decision to expand its Medicaid program, 46 percent of uninsured Illinois residents qualify for either Medicaid or the Children’s Health Insurance Program (CHIP).

Learn about low or no-cost Illinois’ Medical Assistance Programs.

Other ACA reform provisions

The Affordable Care Act established a federal loan program, called the Consumer Operated and Oriented Plan (CO-OP) Program. The program is designed to increased consumer choice and expand competition by enabling new nonprofit health insurers to enter the market.

In Illinois, Land of Lincoln Health received more than $160 million. Land of Lincoln Health has so far struggled to capture many new customers.

Does Illinois have a high-risk pool?

Prior to the reforms the ACA brought to the individual health insurance market, coverage was underwritten in nearly every state, including Illinois.  People with pre-existing conditions often found themselves ineligible to purchase private plans, or only able to get coverage that excluded pre-existing conditions.

The Illinois Comprehensive Health Insurance Plan (ICHIP) was created in 1989 to provide a coverage option for people unable to obtain private plans because of their medical history.  Due to budget shortfalls, the plan stopped enrolling new members in September 2000, and applicants were placed on a waiting list.  The program was able to reopen to new enrollment in the spring of 2001.  The pool also briefly suspended new enrollment in the summer of 2009.

In 2001, the risk pool had about 5,700 members, but that number had grown to more than 18,000 by the end of 2010.

Under the ACA, all new health insurance policies became guaranteed issue starting on January 1, 2014. This reform measure has largely eliminated the need for high risk pools, since medical history is no longer a barrier to obtaining coverage in the individual market.  ICHIP is still enrolling eligible HIPAA pool applicants, but stopped renewing traditional risk pool members’ coverage after April 30, 2014.  They have emailed members and posted extensive data on their website explaining how to transition to an exchange plan.

Health reform legislation in Illinois

Here’s what’s happening legislatively with healthcare reform in Illinois at the state level: