Motion or movement? We’ll know soon enough
Tuesday, Dec 2, 2014 - Posted by Rich Miller
* A long-stalled state-run health insurance exchange bill is starting to move in the House…
A House committee in a 9-6 vote Monday approved legislation creating a state-run website as the legislature begins its final week of the fall veto session.
Supporters of creating a state-run website say an impending end-of-year deadline to receive up to $300 million in federal funding plus a coming U.S. Supreme Court decision on tax credits spurred legislative action. Illinois residents currently purchase insurance on the national HealthCare.gov website.
* More…
During Monday’s meeting of the House Human Services Committee, [Rep. Robyn Gabel] turned aside concerns raised by Kristina Rasmussen, an opponent of the bill and spokeswoman for Illinois Policy Action, a wing of the right-leaning Illinois Policy Institute.
Rasmussen said several states running their own exchange have experienced massive technical problems. Gabel and Sarah Myerscough-Mueller, an aide to Quinn, pointed to other states in which enrollment went smoothly.
Rasmussen said creating a state-based exchange “locks us into larger costs down the road.”
Myerscough-Mueller said a state-operated exchange, which would begin enrolling people in fall 2015 for coverage that begins in January 2016, would cost $72.5 million to run during its first year, $57.5 million the second year and about $50 million each year thereafter.
The $270 million in start-up money from the federal government, which requires action by the legislature on a state-based exchange by the end of 2014, would help cover those operating costs and continue a marketing campaign and other outreach efforts, Gabel said.
* It’s paid for with a provider user fee on policies…
The measure that passed a house committee Monday allows for a 3.5 percent assessment on insurance plans to pay for the exchange.
During a house hearing Monday State Representative Norine Hammond asked Representative Robyn Gabel if the three-point-five percent of health insurance costs to pay for the program could rise with the federal rate. Gabel said the law would cap that, but there are ways around expected increased costs.
“So, and there may be some advocates that aren’t thrilled about this, but a big section of the money would go to marketing, so there would just be a little less marketing,” Gabel said.
Gabel says if the cap of 3.5 percent doesn’t generate enough money to run the state-based exchange lawmakers could come back with a new bill to raise more revenue.
- Not it - Tuesday, Dec 2, 14 @ 10:42 am:
The IPI is am advocacy group funded by national conservative interests who want to tear apart “Obamacare” on a state by state basis. They use stats that support their argument and ignore those that don’t. They compare apples to oranges all the time. For example, with Medicaid expansion all they talked about is how much money is will cost the State, they ignored how much money it would save by eliminating healthcare programs no longer needed.
- Empty Chair - Tuesday, Dec 2, 14 @ 10:44 am:
Does anyone know what the bill # is?
- Judgment Day - Tuesday, Dec 2, 14 @ 10:48 am:
This will be special…. I’m looking forward to seeing who the State contracts with.
And wait until whoever gets chosen finds out they have to interface with our Medicaid system, and it’s AS400 based tech. And all that paper…..
The Auditor General will need to double his staff at the start for this one. They’ll have to rent an 18 wheeler just to move a single copy of the audit report on this project 5 years from now…..
It would be a comedy if it wasn’t so tragic…..
- PMcP - Tuesday, Dec 2, 14 @ 10:59 am:
@Judgment Day
Just about every company that started before the 1990s is on AS400, this is pretty standard territory for any consulting firm worth a damn… Just don’t hire Deloitte
- illinifan - Tuesday, Dec 2, 14 @ 11:00 am:
State interface is already being update and old DOS based model is scheduled to be gone within a year. They have moved to a web based application that interfaces with the new application system. When system is fully aligned the client will be able to set up an account and track their own case. The state used the ACA money to begin necessary updates, and this will help to continue the update process. This was money the state did not have before thus keeping us in the dark ages….we are half way to an updated system.
- Judgment Day - Tuesday, Dec 2, 14 @ 11:07 am:
Last time I checked, the State has been trying to move the different Medicaid software components off the AS400 platform for say, about 19+ years….
They’ve pretty much got some (not sure about all) of the front ends moved off into web based environments, but all the backend DB stuff is all still AS400. Oh, the stories I’ve heard…..
…. or Oracle… or IBM Services…. or CGI Federal….
- Anonymous - Tuesday, Dec 2, 14 @ 11:07 am:
@JudgementDay
SB 636, Floor Amendment #5. The amendment is not yet up on ILGA.
- okgo - Tuesday, Dec 2, 14 @ 11:16 am:
This is pretty simple, pass a state exchange or all those people who have signed up all of a sudden lose their subsidy when the Supreme Court case decides on the typo.
Pretty simple decision.
- Cable Line Beer Gardener - Tuesday, Dec 2, 14 @ 11:18 am:
I have already gotten a robo-call about it-”paid for by the IPA”.
- Wordslinger - Tuesday, Dec 2, 14 @ 11:19 am:
JD, who cares? Policy isn’t driven by what makes life easy for the IT geeks.
How’d you like to be Krista Rasmussen? Get up in the morning and get busy trying to make it harder for people to purchase health insurance. What a gig.
- RNUG - Tuesday, Dec 2, 14 @ 11:20 am:
Taken in the larger context (the lawsuit being heard at SCOTUS over the discount eligibility under the ACA / Obamacare requiring a state operated exchange instead of a federally operated one), this is probably a good move. Otherwise, the state could end up again having even more uninsured and having to pay for their care via Medicaid (I use “pay” loosely given the reimbursement level of Medicaid).
- Sue - Tuesday, Dec 2, 14 @ 11:24 am:
Why does anyone believe illinois will be any more successful or cost effective than the other states who have crafted their own exchange only to see the costs explode and programs suffer tech failures
- Empty Chair - Tuesday, Dec 2, 14 @ 11:32 am:
@Wordslinger
You could argue that creating a state marketplace would be making it HARDER for consumers to get health insurance. Consumers have had a far more difficult time working with state systems, which have had more glitches and less avenues than the federal system. For all its problems, HealthCare.gov is a good model for pooling technology resources efficiently and providing a shared service to multiple states. Why would the state (other than the free federal money) want to re-invent the wheel when there’s currently a properly functioning exchange that already serves (very well, one could argue) the citizenry?
- RNUG - Tuesday, Dec 2, 14 @ 11:37 am:
- Empty Chair -
The case at SCOTUS over the discounts.
- Empty Chair - Tuesday, Dec 2, 14 @ 11:47 am:
@RNUG
I agree that the King case presents high risk for consumers, but the likelihood of the worst case scenario is low.
- Fight Fair - Tuesday, Dec 2, 14 @ 11:47 am:
If the SCOTUS decision in effect kills the viability of the federal exchange, Congress will have a problem far bigger than any one state can remedy. With that ruling pending, the trend is against state exchanges. From an editorial in Sunday’s Tribune:
“Oregon famously spent about $250 million and failed to sign up a single private insurance customer online. Oregon, along with Nevada, has retreated to use the federal site this year. Lawmakers in about a dozen states this year have considered bills that would authorize state-run exchanges, but no state has decided to make the switch, according to the National Conference of State Legislatures.”
- Judgment Day - Tuesday, Dec 2, 14 @ 11:52 am:
IlliniFan:
That’s GREAT news! I’m hopeful, but I have 1 really direct question. Are they finally recreating (new Db model) a whole new backend for the system? (no more AS400 backend)?
In any case, hope you are able to avoid the 95-95 rule of software development on the project.
Good luck.
- Federalist - Tuesday, Dec 2, 14 @ 12:28 pm:
Well, if its supporters are correct and this reduces overall health care costs then there will be no need for the lawmakers to come back.
Would not bet the family farm on that scenario.
“Gabel says if the cap of 3.5 percent doesn’t generate enough money to run the state-based exchange lawmakers could come back with a new bill to raise more revenue.”
- illinifan - Tuesday, Dec 2, 14 @ 1:09 pm:
Judgement….I am not a total computer geek, just have connections with some of IDHS folks who are doing system testing. I understand part of the transition issues they have run into is they no longer have experts in DOS (they have all retired) so they are having problems generally with information migration because of the new programs interfacing with a language no longer used so they plan to eliminate all that old programming. Not sure if that would result in scrapping the AS400….programs like PACIS however will no longer exist.
- Miclyn Mathia - Wednesday, Dec 3, 14 @ 3:57 pm:
I don’t want to subsidize other people’s health insurance, I can hardly afford my own. So when one states the claim that it is subsidized by the federal government, it is in reality subsidized by the taxpayers. Another point of contention, if we all have to be part of a state exchange, our elected officials need to lead by example and partake of the same insurance. This is going to be a costly mistake for every taxpaying American.