Illinois will soon operate its own Affordable Care Act health insurance market, with the power to curb the inflated prices of plans sold there.
Gov. JB Pritzker on Tuesday gave Illinois greater control over health insurance prices and the Affordable Care Act marketplace (also known as the Obamacare Exchange) where people can purchase individual and family health insurance plans. signed two bills aimed at
The bill’s signing on Tuesday came amid criticism directed at Mr. Pritzker for his decision to terminate the enrollment of many people in a separate medical program for immigrants in the country without legal authorization.
One of the bills signed Tuesday would allow Illinois to operate an exchange selling health insurance plans by 2025. Now consumers have to go to federally run exchanges. healthcare.gov Purchase an exchange plan.
At a press conference on Tuesday, Mr. Pritzker called the new law a “monumental achievement” that “will protect Illinoisans from future federal policy changes that seek to undermine access to affordable health care services.” said.
The idea behind this law is to allow Illinois to better reach consumers and protect exchanges from political change at the federal level. Former President Donald Trump made it clear during his tenure that he was not a supporter of the Affordable Care Act and cut much of the funding for outreach and officials who help consumers plan their purchases.
“They’re less susceptible to shifting political winds, so they’re going to be a little more isolated if there’s a change of government at the federal level,” said Sabrina Corlett, a research professor at Georgetown University’s Center for Health Insurance Reform. . .
By operating its own exchange, Illinois could also give consumers more access to health insurance. Currently, consumers can typically enroll in exchange plans only during the open enrollment period from November 1 through mid-January, or when there is some change in their lives, such as the birth of a child or job loss.
Potential for additional registration periods as needed, such as when Illinois operates its own exchange, in the event of a disaster creating a need for health insurance, or when a major employer leaves the state’s territory. Illinois Commissioner Teresa Eagleson said. The field of medical and family services.
Illinois will also be able to better understand which areas of the state need more support and education about exchanges based on the application data, Eagleson said.
Corlett said Illinois will join 18 other states that operate their own Affordable Care Act exchange programs. Health insurers will pay valuations to states, not the federal government, to help operate state-based policies. The state’s budget for next year also includes $10 million to help the exchange ramp up.
The second new law gives Illinois regulators the power to reject or change proposed price increases for individual and small business health insurance plans sold on exchanges, starting in 2026. This law does not apply to health insurance plans offered. Because those plans are federally regulated.
“Being able to go to an insurance company right now and say, ‘This is not going to work,’ is really in our toolbox for protecting consumers,” said Dana Popish Severinghouse, director of the Illinois Department of Insurance. It’s an important tool,” he said. .
Each year, insurers that sell exchange plans are required to publish certain proposed price increases online before they actually do so. Previously, the Illinois Department of Insurance could review premiums and ask insurers to lower premiums if they were too high. But the authorities really couldn’t say no to raising prices.
Illinois consumers have faced double-digit increases in monthly premiums on replacement plans in recent years.
Prices for the exchange’s lowest-cost silver-level plans have risen an average of 11% statewide this year, according to an analysis by the Illinois Department of Insurance.
“We know the prices and costs of healthcare are going up. This is one way state regulators are trying to keep costs down and more affordable for consumers,” he said. said Stephanie Becker, associate director of the association. Medical Justice at the Chicago-based Schreiber Poverty Law Center.
Elliott Richardson, chairman and co-founder of the Small Business Advocacy Council, said at a press conference that the new law could help keep small business insurance prices down.
He said that health insurance prices rising every year is a “hurt” for small businesses. “This bill gives hope that small business insurance premiums will stabilize and eventually come down,” Richardson said.
However, the bill also had a few critics, including the National Association of Mutual Insurance Companies.
“For decades, Illinois has had an open market where consumers benefit from competition among insurers,” said Andrew Perkins, vice president of the Great Lakes Region of the National Association of Mutual Insurers, in a statement. there was,” he said. “While the bill does not directly affect property and casualty insurance, we disagree that regulation is a better way to price products than a competitive market.”
Under the new law, Illinois regulators will be able to reject or change proposed interest rates if they deem them “excessive, unreasonable, or unreasonably discriminatory.” It can also reject interest rates that are too low that jeopardize the “solvency of the insurer.” In 2016, the Illinois insurance company Land of Lincoln went bankrupt, leaving nearly 50,000 Illinoisans scrambling to find new insurance in the middle of the year. Land of Lincoln said it priced it lower than usual in hopes of certain payments from the federal government that weren’t fully realized.
According to Gov. JB Pritzker’s office, the new law joins Illinois with 41 other states that also have the final say on proposed interest rates.
Corlett said there is evidence that final prices tend to be, on average, lower than suggested prices in these states. It’s relatively rare for states to flatly reject proposed interest rates, he said. He said he often deals with insurers in states where he thinks premiums are too high.
“It’s kind of like a negotiation, and you end up agreeing on a rate that both sides can agree on,” Corlett said.
He said insurers don’t typically pull products from state exchanges for such negotiations, but if no agreement is reached, it may not be public knowledge. In Illinois, insurers whose rates have been changed or denied can request a 10-day hearing if they disagree.
Pritzker celebrated the bill’s signature on Tuesday while shielding himself from criticism from Latino lawmakers for changing the country’s immigrant health insurance program without legal authorization. As part of a last-minute budget deal, the program has only about half of the funding it needs for the fiscal year beginning July 1. As a result, Pritzker has decided to close the program registration for people currently under the age of 65 on July 1. Membership Eligibility and Limits for Persons Over 65. Pritzker said the changes were necessary to save the program.
