42 Comments - cassandra - Thursday, Jun 6, 13 @ 10:36 am: A federal marketplace might be better run, I suppose, given Illinois state govt’s difficulties running anything. In any case, I assume this will not affect citizens’ ability to take advantage of the ACA, which is the important thing. - biased observer - Thursday, Jun 6, 13 @ 10:38 am: I agree with Cassandra. its better Illinois is out of the equation. - RonOglesby - Thursday, Jun 6, 13 @ 10:40 am: — A federal marketplace might be better run, I suppose, given Illinois state govt’s difficulties running anything. — How bad is it that we have to admit our state can’t run anything? Isnt that an argument to fix the state, not hand over stuff to the feds? Because you hand over anything to the Feds (or accept anything) it tends to come with long, expensive strings attached to it. - The Southern - Thursday, Jun 6, 13 @ 10:41 am: I don’t particularly care for the direction of our state under Madigan, but this “exchange” plan was destined for failure. ACA itself is obviously unworkable as planned and if Madigan’s daughter is running he didn’t need to borrow this trouble for her and he is wise to throw this back into the “Obama basket” and make this another failure of DC. The cost of insurance in 2014 is going to be the issue of all elections and those politicians with no fingerprints on this issue are the last to lose. Those politicians that can articulate a real workable solution are the first to win. - Bill_Baar - Thursday, Jun 6, 13 @ 10:48 am: I suspect Madigan appreciates what a substantial undertaking rolling out the Market and it’s software would be, and has wisely left it to the Feds. You need a Ross Perot (he who made his fortune processing Medicaid/Medicare claims with EDS) to undertake this kind of thing. Someone’s out there ready to make that new fortune off of Obamacare. It’s beyond the scope of the State of Illinois. Best wait for the disasters to pass with State implementations and let someone else develop it. - Anonymous - Thursday, Jun 6, 13 @ 10:48 am: I, too, agree with Cassandra. This parallels how CMS is looking to replace traditional Medicare coverage + secondary payer with a Medicare Advantage place instead of pursuing the apparently more cost/benefit effective Medicare + Medigap approach. Watch-out when Illinois gov’t wants to run something … into the ground. - Bill_Baar - Thursday, Jun 6, 13 @ 10:56 am: PS Affordable Care Act precludes political donations to State officals while a Federally run exchange would allow them. If that’s true, (I just heard that) I wager it’s a certainity Illinois will never have one. - MOON - Thursday, Jun 6, 13 @ 11:17 am: If Illinois were to have their own Insurance Exchange it would be a disasterous financial boondoggle. Under the Obama Care Law there is no guarantee after 3 or more years that the Feds would continune to provide their stated share of added Medicade costs which the State will incur. Also, there is a subtantial cost to the State to set up the insurance exchange. In essence, the Obama Care is dangling a carrot in front of the State but after 3 years they can change the rules. Thus, the State will have enrolled a substantial number of people under the Medicaide Program and no guarantee of re-imbusements equal to the added cost. This Obama Care Plan. is a disaster. I know their will be a lot of people on this blog that disagree with me regarding this matter. I can only state, do some research before you express an opinion regarding the subject. - WizzardOfOzzie - Thursday, Jun 6, 13 @ 11:29 am: This is totally on the Speaker. No reason this couldn’t pass with the exact same roll call as Medicaid expansion. In light of the early results from California and Oregon there is no reason not to do this. It was a Republican idea. And I thought competition was supposed to help??? And I thought Republicans were for “local control” and “State’s rights”. If that’s the case, why would they want this program run in Washington. The reality is we’re going to have an exchange. It makes more sense to be customized to fit Illinois’ unique market. http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/24/wonkbook-some-very-good-news-for-obamacare/ - WizzardOfOzzie - Thursday, Jun 6, 13 @ 11:31 am: Moon, Maybe you should do some research. First, you’re confusing Medicaid expansion with the exchange. Second, the Feds cover the entire cost of setting up the exchange… THE ENTIRE COST. Go read the article I posted. And also take a look at how well exchanges have worked in Mass and Utah. It’s funny that you ask people to do more research, when, in fact, you are confusing two very different things and making false statements. - RNUG Fan - Thursday, Jun 6, 13 @ 11:46 am: I am sure it was from more of the dive brilliance of the speaker - biased observer - Thursday, Jun 6, 13 @ 11:47 am: mark twain once said, trust arrives in town on foot and leaves on horseback. trust in the state of Illinois has left on horseback (Amtrak?) - MOON - Thursday, Jun 6, 13 @ 11:55 am: WIZZARD You are wrong. The Feds will provide money for 3 or so years. After that there are no guarantees of what level the Feds will support the program. - WizzardOfOzzie - Thursday, Jun 6, 13 @ 12:01 pm: Moon- For Medicaid expansion, the funding level is 90% after, I think, 5 years. The bill passed by the Senate authorizing the State-based exchange has a fee added to the plans that supports the exchange. The federal exchange does exactly the same thing. You are either confusing Medicaid expansion with the exchange (and even then you’re still wrong) or you’re just poorly informed. Please cite an article that supports your position. - Bill_Baar - Thursday, Jun 6, 13 @ 12:02 pm: re: And I thought competition was supposed to help??? ACA limits the kinds of plans. It takes a lot of variation to foster competition and ACA smooths out the variation in Insurance. Insurance Industry really no longer underwrites and develope products; it just processes claims for the Feds (there is an Obamacare Ross Perot out there too waiting to cash in). re: I thought Republicans were for “local control” and “State’s rights”. If that’s the case, why would they want this program run in Washington Because the States resent the Feds setting the rules and the States getting tasked with implementation (and often the expense). Madigan I think wisely left the implementation of the Exchange to the Feds. It’s largely a Software and Marketing effort and I think Madigan wisely backed off. Let the Feds carry the risk of implementation. - MOON - Thursday, Jun 6, 13 @ 12:04 pm: WIZARD Go get a copy of the book which I think is entitled Obama Care…All you need to know. - Formerly Known As... - Thursday, Jun 6, 13 @ 12:30 pm: They have until October 1st to get this up and running. Otherwise no one will care if Quinn or Madigan won, since we’ll all be the losers. And they will both look bad. - L.S. - Thursday, Jun 6, 13 @ 12:38 pm: –This is totally on the Speaker. No reason this couldn’t pass with the exact same roll call as Medicaid expansion– Wizard - do some research of your own. I know at least 3 yes votes on Medicaid expansion that will not vote for a marketplace. That would bring the roll call down to 60, and that’s just based a few conversations. - Old and In The Way - Thursday, Jun 6, 13 @ 12:47 pm: - MOON - Thursday, Jun 6, 13 @ 12:04 pm: WIZARD Go get a copy of the book which I think is entitled Obama Care…All you need to know. You can’t even give us the title of the book and we are supposed to accept your opinion and assessment? Next time take notes! Better yet try reading the real thing before you waste space on this blog! Sheesh….. - MOON - Thursday, Jun 6, 13 @ 12:47 pm: FORMERLY All tax paying citizens are losers as a result of Obama Care. If we let the Feds set up the Exchanges Illinois will end up a winner. Forget the intramural between Quinn and Madigan. - MOON - Thursday, Jun 6, 13 @ 12:51 pm: OLD Thank you for the snide comment. Thats the name of the book. Your handle matches your comment. - MOON - Thursday, Jun 6, 13 @ 12:57 pm: OLD If you need further clarification the book is Obama Care Survival Guide…..All You Need To Know……….. - Old and In The Way - Thursday, Jun 6, 13 @ 1:07 pm: MOON I’ve scanned the book you reference and frankly it’s slanted to the point that’s its almost worthless. There are many legitimate issues with the ACA and trash like this doesn’t help either frame the discussion nor address the problem. I may be old but I am also experienced and given my thirty plus years as a lawyer I think qualified to comment. At least the Illinois Supreme Court and SCOTUS think so since I have tried cases in both courts. - ProblemChild21 - Thursday, Jun 6, 13 @ 1:10 pm: Moon and Wizard - All kinds of claims about how all of this will work, both now and in the future. Main problem is that the legislation and rules are so long and dense that Ron Hubbard himself couldn’t have made sense of it. There will be some good, there will be some bad, and there will be some ugly, but only time will tell whether the overall effect of the law and rules is a good thing or will bring us to our knees. Arguing specific authors and politicians prior to that point will get us nowhere. - dave - Thursday, Jun 6, 13 @ 1:19 pm: So much misinformation in this thread… First, the feds and IL have entered into a partnership for at least the first year for the Illinois Health Insurance Marketplace. This will be up an running by 10/1/13, and will at least run through 2014. So a state-based marketplace (rather than the partnership), would not need to be up and running until 10/1/14 at the earliest. Second, MOON’s comments about funding and MOON’s confusion about the difference between Medicade [sic] and the exchange, are just flat out wrong. The feds will provide ALL the funding to implement an exchange, and after that it will be paid for by assessments on insurance providers. This is NOT contingent on future changes by Congress. Third, on Medicade [sic] funding. Current law states that the Feds will cover 100% of the expansion costs for the first three years, and then will phase down to 90% by 2020. In order for this to change, the law would have to change. And IL’s law that authorizes the expansion of Medicaid says that if the federal match rate goes below 90%, the expansion goes away. So if your “Obama Care” book tells you otherwise, it is flat out wrong. But hey, lets not let any facts get in the way. - MOON - Thursday, Jun 6, 13 @ 1:19 pm: OLD So you “scanned the book” well I read it. There is a difference. You are free to comment, its your conlusions that are wrong. “you are in the way” as well as old - Publius - Thursday, Jun 6, 13 @ 1:19 pm: I was around when Johnson passed medicare…the world was going to end…all we would have was socialized medicine…the federal government couldn’t run a damn thing…..well, guess what, medicare works just fine…the government isn’t screwing up our medical care, and there are hundreds of thousands of private individuals and companies making tons of money in health care. Medicine isn’t socialized. The wacko conspiracy theories weren’t right then, and they aren’t right now. - illinifan - Thursday, Jun 6, 13 @ 1:24 pm: Thanks Wizzard of Ozzie for posting correct information about the differences between funding for the Medicaid expansion vs. funding for the Marketplace (Health Insurance Exchange). Illinois is operating partnership exchange with the Federal government where we have increased input on what is happening but not full input. Some states have chosen to the federal only exchange, where the feds dictate what happens. For a full state operated exchange, the state has more control over what happens but gets to use federal money. This is what California chose and they believe this helped when the plans were offered and posted show the premiums are 30% lower than current insurance premiums in the California market. Illinois by passing the buck did not save money, they just relinquished control. It is more helpful to read reports from places like Kaiser Family Foundation or Robert Woods Johnson to get facts vs. the myths spread about ACA. Like Problem Child said, some will be good, some bad and some ugly as this whole plan roles out. Just like it happened when Medicare first started and Part D later started. Now try and pry those red white and blue cards out of the hands of seniors. - Old and In The Way - Thursday, Jun 6, 13 @ 1:26 pm: DAVE Thank you. Moon obviously confuses reading with comprehending. - MOON - Thursday, Jun 6, 13 @ 1:59 pm: DAVE What you fail to realize is the fact that thousands of people currently not on Medicaid will enroll. When the Feds do phase down to 90% the State will have all these additional people on Medicaid. Also, there is no guaratee that the Feds cannot change the law and reduce their level of support. Our law does allow us to get out if the Fed match goes below 90%; but how do we now pay for all the new people on Medicaid? - WizzardOfOzzie - Thursday, Jun 6, 13 @ 2:08 pm: re: And I thought competition was supposed to help??? ACA limits the kinds of plans. It takes a lot of variation to foster competition and ACA smooths out the variation in Insurance. Insurance Industry really no longer underwrites and develope products; it just processes claims for the Feds Bill Baar- Go back and read the article I linked to. It’s an account of what’s actually happening in State’s that have created State based exchanges. It actually works. MOON- You’re beyond help. You clearly have no clue what you’re talking about. - WizzardOfOzzie - Thursday, Jun 6, 13 @ 2:10 pm: And MOON- Other books on Amazon frequently bought w/ the Obamacare Survival Guide you cite- Beating Obamacare Control: Exposing the Truth about Guns by Glen Beck Very objective analysis I’m sure. - biased observer - Thursday, Jun 6, 13 @ 2:13 pm: we don’t need any more illinois bureaucracy, especially regarding healthcare, no matter who pays for it. - Demoralized - Thursday, Jun 6, 13 @ 2:13 pm: @MOON: Newsflash. The Affordable Care Act is the law of the land. The sooner people start working on implementing and stop whining about it the better. Oh, and you are wrong in your analysis. You should stop while you can before you keep making yourself look foolish. - Mokenavince - Thursday, Jun 6, 13 @ 2:27 pm: As Madigan goes into hiding, it really give’s me incentive not to vote for his daughter. Let’s all chip in and give Magic Mike a cell phone. $17 million going down the drain per day in Springfield . And nobody really cares I’m amazed that by that fact. - WizzardOfOzzie - Thursday, Jun 6, 13 @ 2:32 pm: L.S., What kind of research do you mean? You do realize that Marketplace vote is a better vote for some of the targets who were taken off then Medicaid Expansion, right? - wordslinger - Thursday, Jun 6, 13 @ 3:28 pm: –What you fail to realize is the fact that thousands of people currently not on Medicaid will enroll. When the Feds do phase down to 90% the State will have all these additional people on Medicaid. Also, there is no guaratee that the Feds cannot change the law and reduce their level of support.– In the absolute worst-case scenario, you wouldn’t take $9 for every buck you put up to get poor people health coverage? Your opposition can’t be based on finance; it has to be some sort of ideological tick. Even Jan Brewer, Rick Scott and John Kasich can do the math. I have a flash for you: those folks are showing up in emergency rooms and getting very expensive, lousy health care. They can’t pay, and that cost is passed on to those of us already paying out the nose for private health insurance. - Just Me - Thursday, Jun 6, 13 @ 3:51 pm: This actually doesn’t upset me so much. Let’s have the federal government run/pay for an exchange for a year first before we decide if we want to do it ourselves. - Cincinnatus - Thursday, Jun 6, 13 @ 4:05 pm: “In the absolute worst-case scenario, you wouldn’t take $9 for every buck you put up to get poor people health coverage?” I hear you push this argument all the time, last time being something about roads and high speed trains. What happens when you don’t have the buck to spend? - wordslinger - Thursday, Jun 6, 13 @ 4:19 pm: –What happens when you don’t have the buck to spend?– You’re spending that buck, and much more, in insurance premiums and medical costs for the expensive services provided to the uninsured. Gov. Brewer gets it. So do Govs. Scott and Kasich. Gov. Romney understood it before everyone else. - k3 - Thursday, Jun 6, 13 @ 4:21 pm: What a joke. Might as well have Republicans control the house. Zero difference. - WizzardOfOzzie - Thursday, Jun 6, 13 @ 5:23 pm: Speaker Madigan’s reluctance to implement Obamacare in the President’s home state is probably the most interesting story that hasn’t been covered this session. Sorry, comments for this post are now closed.