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Top Ten Things You Should Know About lllinois Health Care Reform
 
On February 7, 2011, Governor Quinn's Illinois Health Care Reform Implementation Council held a public hearing to release its initial recommendations  on the implementation of the Affordable Care Act in Illinois. The  recommendations, which include issues that the state must address  immediately and decisions that will be made after the Council gathers  more information from stakeholders and the federal government, were  offered to the public to review and comment; however, the  recommendations will be fine-tuned before final recommendations are  presented to the Governor.
The report is a fairly short  19 pages and easy to read, but if you want the "Cliffs notes" version,  here are the top 10 main take-aways from the meeting: 
- The  Council recommends that Illinois (rather than the federal government)  create a state based Health Benefits Exchange, which is the centralized  marketplace that in 2014 will provide individuals and small businesses  with access to more affordable, comprehensive health insurance coverage  options. 
- The Council recommends that the Exchange should be run by a  quasi-governmental entity led by an appointed board of directors. This  administrative structure is similar to the Illinois Comprehensive Health Insurance Plan Board and the Office of Health Information Technology.
 
- The Council does not recommend a preferred way to finance the  administration of the Exchange at this time although it specifies that  funding should not come from the state general revenue funds. The  Council is still considering an assessment on insurance companies,  providers and others who will benefit from broader health insurance  coverage, as possibilities for revenue sources.
- The best current estimate of the number of uninsured in Illinois is   about 1.5 million. Of these, the Council estimates that in 2014,  between  500,000-800,000 people will be added to Medicaid, between  200,000 and  300,000 people will purchase subsidized coverage through  the Exchange  and between 300,000-600,000 people will remain uninsured.  Another 1  million Illinoisans who are currently insured will get  private insurance  through the Exchange, much of it with some subsidy.  Unlike in the past,  Medicaid and private insurance will be merged into  one centralized marketplace.
- The Council recommends that the state continue to engage employers,  consumers and insurers, because successful implementation of the  Exchange will necessitate a strong outreach and education component,  including working with community-based Navigators and insurance brokers.
 
- The Council recommends that the state take all available avenues to   review and control rate increases in the insurance premium market as   soon as possible. Additional information can be found on the Illinois Department of Insurance website.
 
- The Council recommends convening a Healthcare Workforce work group  to develop an aggressive, comprehensive plan to professional and  paraprofessional healthcare and public health worker shortages  statewide, now and in the future.
 
- The Illinois Health Information Exchange (HIE)  strategic and operational plan was approved by the federal government  in December 2010. It focuses on the adoption and meaningful use of  electronic health records; ensuring that providers who wish to begin  exchanging health information electronically in 2011 can do so;  developing an all payer claims database and other priorities which can  be found here.
 
- The Council recommends waiting for further guidance from HHS before deciding whether to require benefits beyond the ?essential benefits? defined by HHS. 
 
- The Council does not recommend early implementation of Medicaid  expansion in Illinois (i.e., beginning to enroll people under 133% FPL  before 2014) but remains open to considering changing the moratorium on new expansions if a financially advantageous opportunity for the State arises.
Stephanie Altman
Health & Disability Advocates 
  
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