SPRINGFIELD — Illinois lawmakers are moving forward with legislation to create an online health insurance exchange despite not knowing who will pay its nearly $89 million price tag.

By Benjamin Yount

SPRINGFIELD — Illinois lawmakers are moving forward with legislation to create an online health insurance exchange despite not knowing who will pay its nearly $89 million price tag.

“We want people to be able to log on, type in their information, be told, ‘This is what you qualify for,’ and then be able to buy it,” said state Rep. Frank Mautino, D-Spring Valley.

Mautino introduced legislation last week that would create the online marketplace with a governing board and framework to pay for the exchange.

Each state must have a fully operational health insurance exchange by 2014, according to the federal Patient Protection and Affordable Care Act. However, the law requires Illinois lawmakers to create an exchange by June 2012, so the state can test the exchange model by 2013.

If Illinois does not meet the 2012 deadline, the federal government will impose its own insurance exchange on the state.

Mautino, who heads the legislative committee charged with creating the exchange, said he intends to present his proposal to lawmakers during the second week of the veto session. He admits the state could vote on the exchange in the spring, but Mautino said he wants a vote as soon as possible “to be that much farther ahead.”

“We need to have a governing board, a list of their duties and a way to pay for the exchanges in place before next spring,” Mautino said. “That way we can apply for federal money to build the exchanges.”

Who Pays?

The central question now facing Illinois lawmakers is who will pay to run the health insurance exchange after 2014.

The federal government only is providing millions in one-time, use it or lose it, grant money to set up the high-tech electronic insurance exchange.

A study released in September by the Boston-based consulting firm the Wakely Group estimates Illinois’ yearly operation costs somewhere between $57 million and $89 million.

Mautino’s legislation would impose an assessment, or a dedicated use fee, on insurers to pay for the online marketplace.

He based his proposed exchange on Illinois’ Comprehensive Health Insurance Program, or CHIP, a pool of insurance plans for children from low-income families.

“We’re talking about an assessment (for CHIP) that’s anywhere between $75 million and $55 million last year,” said Mautino.

Jim Duffett, executive director for the health-care advocate The Illinois Campaign for Better Health Care, said, “We do not think ($89 million) should be paid for by the people who will use this exchange.”

But others balk at the idea that Illinois’ insurance exchange should cost nearly $90 million.

“I think it’s ridiculous to spend that much,” said state Sen. Bill Brady, R-Bloomington. “We still don’t know what the federal government is going to require. To do anything before the Supreme Court decision is premature.”

The U.S. Supreme Court is expected to hear cases, challenging the constitutionality of the federal health care law’s individual mandate, this session.


In addition to the up to $89 million yearly operating price tag, the Wakely report breaks down what an exchange would cost people who seek insurance through the new marketplace.

The report details a per-person, per-month cost between $9 and $13, with 486,000 people expected to enroll in the health-care exchange in 2014, and 1 million by 2016.

Duffett is quick to say the number of enrollees could be higher.

“Right now there are 1.7 million people in Illinois without insurance,” Duffett added “This exchange is expected to serve 1.4 million of those uninsured people.”

Illinois’ Medicaid population, currently 1.8 million people, Duffett said, is also expected to drift in and out of the exchange.

In addition to meeting federal deadlines, Illinois is rushing to secure federal dollars.

Mautino said $59 million for implementation of the exchange and another $94 million for computer and technology infrastructure will be made available in March.

The $94 million is earmarked, both by Illinois lawmakers and the federal government, for technology to create a health insurance exchange.

Mike Claffey, spokesman for the Illinois Department of Health Care and Family Services, said the agency’s computers “date to the 1970s and are very antiquated.”

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1 Comment

  1. I guess they will need to raise taxes

    Leave it to a Democrat to submit a bill that will raise taxes, again. Mautino must lack the brain power to realize that federal funding will only be short term, one year. This is assuming that the health care plan will be declared constitutional and that is a slim chance. Experts predict that it will be unconstitutional by 7 to 2 or 9 to 0 vote.

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