State Rep. Darlene Senger, R-Naperville, has joined the call to delay enactment of a key provision in the federal Affordable Care Act.
The “individual mandate” that requires most Americans to obtain health insurance or be subject to a tax penalty survived a constitutional challenge in 2012 when the Supreme Court cleared the way for its implementation. Still, it continues to be challenged by conservative lawmakers, some of whom say time is running out for consumers to meet the requirements for the scheduled full rollout of the act seven weeks from now.
Senger introduced House Resolution 680 in Springfield on Tuesday, and Rep. Ron Sandack, R-Downers Grove, and three other GOP House members joined her as chief cosponsors the following day. Another 39 of their remaining 42 Republican peers also signed on as cosponsors Wednesday.
The bill mirrors a similar effort, also launched Tuesday, by U.S. Rep. John Shimkus (R-Collinsville), who represents southeast Illinois’ 15th Congressional District. Shimkus’ letter to Illinois Department of Insurance Director Andrew Boron was cosigned by Rep. Randy Hultgren, R-48th; Rep. Peter Roskam, R-6th; and three other members of the Illinois GOP delegation.
Senger’s bill cites delays that have arisen because of technical problems with the federal website healthcare.gov, set up as a way for consumers to access their insurance choices, in pushing for postponement of the individual mandate.
Staff members at the DuPage County Health Department, however, are proceeding in anticipation of the site being fully functional soon, according to spokesman Jason Gerwig.
“Right now we are in full education mode, helping those who quality for the marketplace pull together the information they need to enroll,” Gerwig said in an email, noting that significant improvements to the site are expected by the end of November. “At that time, we’re excited to start getting people fully enrolled.”
Federal officials say things are improving. In an update issued Wednesday, the Department of Health and Human Services said teams working on the rollout woes are introducing “multiple software releases” weekly.
“Because performance teams are dedicated by category, they are becoming increasingly proficient in developing fixes quickly and building an ongoing pipeline of improvements for implementation,” the agency said in a statement. “If a fix becomes too complex to deploy rapidly, it is assigned to a dedicated escalation team to address.”
Senger’s proposal also presses for more detailed information from Boron and the state insurance agency about the number of residents who will have to change their health coverage plans.
Senger — one of the local Republicans seeking to unseat U.S. Rep. Bill Foster, D-Naperville, in next year’s House race — said other states have reported “tens of thousands” of policy cancellations.
“Right now, Illinois families are in the worst spot,” she said in a news release. “Those that need insurance can’t get it, and many that have insurance are losing it.”
Under the ACA, a segment of the 5 percent of U.S. consumers now in the individual insurance market will be required to switch plans as insurance providers adopt a more comprehensive set of minimum benefits. Once enacted, the feature will phase out the bare-bones policies, and people now under that coverage have begun receiving notices of the impending change.
According to a spokesman for the Illinois Hospital Association, however, quantifying those consumers won’t be a simple matter.
“It’s really going to be hard to figure out ahead of time how many of these plans didn’t meet the minimum criteria,” said Danny Chung, vice president of corporate communications and marketing for the IHA, which is based in Naperville. “You’re talking about, in each state, thousands and thousands of plans.”
The proliferation of minimal-coverage policies is a relatively recent phenomenon. The number of underinsured Americans almost doubled between 2003 and 2012, according to estimates from The Commonwealth Fund, as employer-based coverage sharply declined. The largest growth in the demographic was seen in middle-income workers earning $40,000 to $50,000 annually, whose pay was too high to qualify them for Medicaid but who weren’t earning enough to cover the premiums for the plans offered through their employers. In response, many insurance companies began offering the no-frills policies, which typically come with low premiums and high deductibles.
The health reform legislation effectively will outlaw that coverage. Beginning on Jan. 1, 2014, insurers must cover 10 categories of care: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.
It’s a notable shift from the caliber of policies being discontinued.
“There were all kinds of individual health insurance plans, some of them really cut-rate,” Chung said. “So a lot of people may have thought they had great coverage at a low rate, because they never had to dig deep and use that policy. ...That’s why there’s all this angst and surprise.”
The pending state bill, House Resolution 680, notes that numerous delays already have been assured in the act’s implementation, including postponement of the employer mandate, a requirement for caps on out-of-pocket insurance costs and enforcement of checks on eligibility for subsidized coverage. The bill has been referred to the House rules committee.