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Regulation and Compliance > State Regulation

Illinois exchange bill stalls

By Carla K. Johnson

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CHICAGO (AP) — State lawmakers in Illinois adjourned Friday without sending Gov. Pat Quinn, D, a Patient Protection and Affordable Care Act (PPACA) exchange bill.

Quinn has been trying to get an exchange bill signed into law for three years.

Because Illinois has not yet moved to set up its own, state-based exchange, the U.S. Department of Health and Human Services (HHS) could end up providing exchange services for its residents for years to come.

Quinn had hoped the state could start preparing to take control of the Illinois exchange by 2015.

Illinois seems to be unlikely to be able to stick to that timetable, unless lawmakers pass exchange legislation when they convene for an abbreviated veto session this fall.

Jim Duffett of the Campaign for Better Health Care, an Illinois group that supports PPACA, predicts that if lawmakers don’t approve a state-run exchange in the fall, there won’t be one in Illinois for at least five years.

State senators approved the bill along party lines, but the full House never voted on it before last Friday’s adjournment. A spokesman for House Speaker Mike Madigan noted the bill “didn’t have much bipartisan support” in the Senate and would have had “tough sledding” in the House.

Illinois — Obama’s home state — has been slower to implement major PPACA programs than many other Democrat-controlled states have been.

Illinois officials are expecting an HHS-run Illinois exchange to open Oct. 1 and offer 165 policies, or “qualified health plans” (QHPs), from six carriers.

The Illinois exchange bill’s main Senate sponsor was Sen. Dave Koehler, D-Peoria. Koehler said he’s working with others to convince more House members to pass a state-run exchange bill in the fall.

“If we want to control the destiny for Illinois, we need to have a state-based exchange,” Koehler said.

Quinn spokesman Mike Claffey said the governor’s office will work with Koehler and others “to craft legislation that can pass both houses of the General Assembly later this year. The fall veto session is Oct. 22-24 and Nov. 5-7, so there is an opportunity to pass legislation in the fall.”

Consumer advocates, who want a state-run marketplace, are pessimistic.

“The picture looks really bleak for a state-based exchange in 2015,” said Brian Imus of Illinois Public Interest Research Group. “There’s going to have be leadership from Speaker Madigan to make it happen and a willingness from legislators to stand up to the insurance industry.”

Madigan spokesman Steve Brown said it’s not a question of the speaker’s leadership.

“People, when they fail to accomplish something, tend to blame someone like Mike Madigan,” Brown said. “I don’t recall the bill’s sponsors pushing for a vote” in the House, he added. The bill didn’t have bipartisan support in the Senate, Brown said, and “it probably would have been tough sledding if it had been called” in the House.

The Illinois Legislature did pass another key element of the law: an expansion of Medicaid to cover most low-income adults without children at home. A U.S. Supreme Court decision last year made the Medicaid expansion optional for states. In Illinois, the Senate voted along strict partisan lines to expand Medicaid. In the House, some Democrats voted “no” on Medicaid expansion, although the measure passed.

“Medicaid expansion was the first big thing that needed to happen,” Duffett said. “I can only speculate that Madigan did not want House members to take a second vote on Obamacare.”

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