Legislation allows state-based market, rate review
By PETER HANCOCKIllinois Capitol News[email protected]
SPRINGFIELD — Governor JB Pritzker on Tuesday signed legislation that will dramatically change the health insurance market in Illinois.
The measures establish a state-based exchange for policies sold under the Affordable Care Act and give the Illinois Department of Insurance the power to modify or reject proposed rate increases.
“From day one of my administration, I have been committed to making health care more equitable, holistic and accessible,” Pritzker said at a bill signing ceremony in Chicago. “With these bills, we are not only increasing access to affordable preventative care, we are improving the quality of life for millions of people who call Illinois home.”
Under the Affordable Care Act, people who are not eligible for Medicaid but do not have access to affordable health insurance through their employer can purchase subsidized policies through an online exchange operated by the federal government or their state government.
Illinois, however, was among the states that chose not to establish their own stock exchange. Instead, it pays an annual fee so Illinois residents can use the federal exchange.
This will change under House Bill 579which calls on the Department of Insurance to set up a state-run exchange that will be fully operational by 2026.
Dana Popish Severinghaus, Director of the Department of Insurance, said in an interview after the bill was signed that having a state-based exchange will ultimately make it easier for consumers to find insurance. Illinois.
“I think it’s ultimately our goal that consumers in Illinois can have one-stop shopping where whether they need to enroll in an ACA plan or a Medicaid plan or, you know, their family is divided, we can do it in one place to make it as easy as possible,” she said.
Pritzker said Tuesday that having a state-based exchange would give Illinois the flexibility to offer more enrollment periods during the year than federal exchange offerings and to coordinate. with nonprofit organizations that help people navigate the market.
But perhaps more importantly, Pritzker said, it will protect Illinois consumers from any potential changes in federal policy. During the Trump administration, funding for advertising and non-profit groups to help people get insurance was cut, and the annual number of registration days was cut by about half.
“I’m suggesting that if Joe Biden lost re-election to a Republican, people would lose their nationwide health care coverage or lose access to this federal exchange, but they wouldn’t lose access to the Illinois exchange,” Pritzker said. .
Pritzker also signed House Bill 2296which, for the first time, gives Illinois insurance regulators the power to review health insurance rate changes and, if necessary, modify or reject proposed changes – authority that regulators in 41 other States already own.
Under the bill, from 2025, companies that offer individual and small group health insurance policies will have to submit their rate proposals for the following year to the Department of Insurance, which will publish these offers on its website. website. After a 30-day public comment period, the ministry will approve, modify or reject the proposed tariff changes.
The bill also directs the department to publish an annual report on health insurance coverage, affordability, and cost trends in Illinois, including things like cost trends by major service category. , including prescription drugs; usage patterns by major category of services; the impact of benefit changes; enrollment trends; and demographic changes.
State Senator Laura Fine, D-Glenview, said in a separate interview ahead of the bill’s signing that these changes will make health insurance pricing more transparent to consumers and give regulators the ability to determine whether consumers are overcharged.
“The insurance industry files its plans with the Department of Insurance, and although the department goes through the actuarial process, it cannot reject a rate,” she said.
Under the new law, she said, regulators will be able to reject unreasonably high rates as well as rates so low they could put the insurance company at financial risk.
Capitol News Illinois is a nonprofit, nonpartisan news service covering state government. It is distributed to hundreds of print and broadcast media throughout the state. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation, with major contributions from the Illinois Broadcasters Foundation and the Southern Illinois Editorial Association.