Illinois updates financially cloudy health reform plans

MedIll reports:

The panel struggling to figure out how Illinois will implement federal health care reform, Wednesday released a financially vague roadmap highlighting just how little citizens — and lawmakers — know about how the new law will work in Illinois.

One of the key tasks facing the state is creation of an insurance exchange to provide access to affordable insurance to those who otherwise can’t get it. The Obama health care law requires all states to offer universal access to health insurance.

Policymakers face two initial obstacles: disagreement on who to include in the exchange and how to fund it. A council created last July by Gov. Pat Quinn is wrestling with those and other issues. The General Assembly will ultimately make the decision.

The General Assembly can be expected to start work on “a lot of moving parts” before May, said Mike Claffey, spokesperson for the Health Care Reform Implementation Council.

The council suggested establishing an insurance exchange created by the state government but with an independent board of directors responsible for funding and running it. While insurance companies, potential patients and the advisory board disagree on who to include in the exchange, all parties agree that Illinois should create its own exchange before a deadline that would cause the federal government to impose one.

“Nothing is a done deal at this point,” Claffey said. “We’ll see what happens legislatively this year, and there might be other issues once we have more information from Health and Human Services.”

Once the exchange is created, the board of directors is faced with paying for the program, including how to spend federal funds and what to do if those funds run out.

“These are issues that the board of this exchange, when it’s created will have to tackle,” Claffey said. “As you know, the state is in a financial crisis … But one of the positive things from the [federal health care reform act] is that it helps solve some of our financial concerns on the health care front.”

But Dr. Steve Malkin, president of the Illinois State Medical Society, said any funding coming from the state of Illinois is suspicious, as the state is chronically late with Medicare and Medicaid payments.

“The state has not paid the medical bills for the state employees in six months. So when you look at the state proposals and what they want to do with health care reform you have to keep in mind that they don’t even have money to pay the bills they have now,” Malkin said.

“There’s the theory of what you’d like to see and where you’d like to go, and the practical standpoint of how are you going to get there,” Malkin said.

Much about this exchange is “complete speculation until you know the exact facts,” said Dr. Joel Shalowitz, director of the Health Industry Management Program at Northwestern’s Kellogg Graduate School of Management.