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Illinois to move ahead with health insurance exchange

Published: Tuesday, Nov. 6, 2012 5:30 a.m. CDT

CHICAGO – Illinois officials are reviewing five bids to build the state’s health insurance exchange – a required component of the federal health care overhaul that Gov. Pat Quinn intends to implement regardless of who wins the presidency on Election Day.

By 2014, each state must have a working exchange where people and small businesses can comparison shop online for commercial health plans based on quality and cost. The concept has been described as Travelocity for health insurance, and it’s intended to make buying insurance simpler and more affordable.

Republican presidential candidate Mitt Romney has expressed support for states setting up their own exchanges, although he’s said he would work with Congress to repeal the health care law that he and other Republicans have derided as “Obamacare.”

That means Illinois and many other states could push ahead with the exchanges if Romney wins, according to Brian Patt of Reston, Va.-based Infosys Public Services, which is one of the five companies bidding on the Illinois contract.

“Fifteen states are in process now, including Illinois, and they represent about half the population of the country because they are the larger states,” Patt said.

“These states decided early on this makes sense to manage their own exchanges,” rather than have the federal government do it, Patt said. If Romney wins, “all he’s going to do is shift the model over to the states and they’ll end up with something very similar” to what they’re working toward now.

Obama’s health care legislation focuses on covering most of the uninsured and requires nearly every U.S. resident to have coverage. Illinois officials estimate about 800,000 uninsured residents would have coverage in 2014 because of the law, and that the figure will have eclipsed the 1 million mark by 2020.

Under the health care law, states that don’t run their own exchanges or partner with the federal government to do so will see Washington step in and take over.

Heather Howard, director of the State Health Reform Assistance Network, said that if Romney wins, Democrat-led states such as Illinois could argue that they should receive the same type of federal help that Massachusetts got in support of its health reform when Romney was governor there, which was roughly $385 million.

The Illinois Department of Insurance has received proposals on the exchange contract from Infosys, CGI, Deloitte Consulting, Xerox and Cognizant Technologies Solutions.

The contract would require the work to be done in the United States, and Patt said Infosys would locate its Illinois exchange operations within the state.

The company that wins the bid would be required to design and build a website with “no wrong door” for consumers – a user-friendly site that would seamlessly guide them to Medicaid, the children’s health insurance program or private insurance, depending on each consumer’s eligibility. The exchange would need to share data with Illinois’ Medicaid agency. Consumers would be able to find out whether they’re eligible for new federal subsidies to help pay premiums, or whether they qualify for Medicaid.

“It’s a fairly daunting challenge quite honestly,” Patt said.

Illinois would take over full management of its exchange in 2015, the second year of the national health law’s full implementation. In the first year, Illinois plans to partner with the federal government, said Colleen Burns of the Illinois Department of Insurance. If the state’s plan is approved, the federal government would run the website and a call center. The state would decide which insurance plans qualify to be sold on the exchange and provide in-person consumer assistance.

“Our intent is to partner with the federal government for the first year. Once legislation has passed, we can bridge to a full state-based exchange for 2015,” Burns said.

Spokeswoman Brooke Anderson said the governor plans to proceed with plans no matter who wins the election.

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AP Medical Writer Carla K. Johnson can be reached at http://www.twitter.com/CarlaKJohnson .

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