Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=224219
Story Retrieval Date: 4/24/2014 2:04:16 PM CST

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Catherine Brzycki/ MEDILL

The Dill Pickle Food Co-op in Logan Square offers health benefits for employees. It's considering enrollment in the Illinois Marketplace.


Confusion surrounds opening of Illinois Health Insurance Marketplace

by Catherine Brzycki
Aug 27, 2013


Suzanne Murray, a 61-year-old piano teacher, is considering buying health insurance from the Illinois Health Insurance Marketplace, especially if a plan is offered that would provide increased coverage or lower rates than she’s paying now. But she doesn’t think she has enough information to make an informed decision.

“I’ve heard nothing from the state of Illinois,” said Murray, a Schaumburg resident who subscribes to the Chicago Tribune and the Daily Herald and says she listens to WBEZ Chicago every day. “What I’ve heard is just general information. I’m just not clear on it.”

In one month, Illinois residents will be able to sign up for health insurance through an online marketplace created under the Affordable Care Act. But many people, like Murray, are confused about when and how to enroll.

The Illinois marketplace will open on Oct. 1 for coverage starting Jan. 1. Although nearly 1 million Illinoisans will become eligible for new health care coverage in 2014, the Illinois Department of Insurance expects only 486,000 individuals to enroll. By 2020, state officials hope that number reaches 1.9 million.

“I think there’s confusion and there’s been so much misinformation out there that people are asking, what’s going on?” said Joyce Harant, the small business project director for the Campaign for Better Health Care.

Among the questions with no clear answers for Illinois consumers is how much, specifically, coverage will cost.

Murray and her husband have paid out-of-pocket for private insurance for over 20 years. Because Murray is self-employed and her husband owns his own business, their insurance costs $900 dollars per month with a $2,500 deductible each.

 

Everyone, including the Murray's, will have a choice of four levels of coverage with different price points and coverage options. These will be available in all states, including Illinois.

 

The cheapest level, the “bronze” plan, will cover about 60 percent of a patient’s medical expenses. “Platinum” plans will cover at least 90 percent of medical costs but will charge the highest premiums. Gold and silver plans will also be made available.

According to the Kaiser Family Foundation’s subsidy calculator, the Murray's are not eligible to receive any government tax credits because their combined income level is at least triple the federal poverty level. Their premium would average around $1,400 a month, $500 more than they are currently paying, based on a silver plan. The bronze plan would only average $1,000 a month, but could carry higher out-of-pocket costs.

 
Those who choose not to enroll in a health care plan, either through their employers or through the state's marketplace, will face a fine that is 1 percent of their income in 2014, or $95 per person, whichever is higher. The most a family would have to pay in 2014 is $285. After 2014, fines will increase, according to healthcare.gov.

 
Medicaid will cover families who make less than 133 percent of the poverty line, or about $29,000 for a family of four. The families who fall between 133 percent and 400 percent of the poverty line, about $88,000 for a family of four, will qualify for tax credits on a sliding scale. The federal poverty level for a family of four is $23,550. For an individual, the federal poverty level is $11,490, according to the U.S. Department of Health and Human Services.

For the Affordable Care Act to work as intended, millions of healthy, uninsured Americans must join a health plan to counterbalance the number of sicker Americans who are likely to buy insurance. Otherwise the health plans offered through the state will have to raise premiums to offset the costs.

To ensure residents sign up for coverage through the marketplace, Illinois has received approximately $28 million in federal grants to recruit organizations to participate in the In-Person Counselor Program. In late July, the state awarded the grants to 44 groups who will act as counselors. Those organizations are in the process of recruiting trained and certified counselors to serve as resources for those choosing a health plan.

The Illinois Aids Foundation is one organization that received a grant. Ramon Gardenhire, director of government relations, says he hopes to have six to eight people by the end of August who will be fully trained and certified for counseling by Oct. 1.

“We will have the option where people can come in and have an in-person assistor walk them through the application process,” said Gardenhire. “We have an onslaught of information and we need to make it digestible for everyone.

In addition to the counseling program, the state plans to open a call center in October to field questions and direct consumers to the appropriate departments that can answer questions ranging from simple to complex issues about health insurance.

 
The Illinois Department of Insurance confirmed six insurance companies applied for inclusion in the Marketplace: Blue Cross and Blue Shield, the state’s largest health insurance market; Humana Inc. of Louisville, Ky.; the insurance arm of Carle Foundation, a nonprofit hospital in Urbana; Aetna Inc. of Hartford, Conn.; Coventry Health Care Inc. of Bethesda, Ma; and Land of Lincoln Health Inc. Co-op. The submitted plans are currently under review with the U.S. Department of Health and Human Services.

 

However, the second-largest health insurances company in Illinois, UnitedHealthcare Group has opted out of the Illinois exchange.

 

An announcement will be made in September about the final list of companies who will provide plans in Illinois' marketplace. 

 

Officials in 14 states and the District of Columbia will run their own exchanges. The U.S. Department of Health and Human Services, which will run or partly run exchanges in 36 states. The Illinois Marketplace will be a joint-partnership with the federal government.

 
Earlier in July, the public relations firm FleishmanHillard Inc. won a $35 million contract to market and promote the state’s insurance marketplace. The state intended to make the campaign public by the end of summer, but as August draws to a close, Maxine Winer, senior partner and general manager of FleishmanHillard Chicago said there is no reason to worry.

 
“We’re not really concerned at all,” said Winer. “We’ve got a great process in place.”

 
In order to apply to carry the state’s message, FleishmanHillard had to present a fully developed outreach program to the state of Illinois.

 
“At this point what we’re doing is finessing and finalizing the details of the program,” said Winer. “There’s a lot of time saved there because the time was put in up front.”

 
Winer said the campaign’s outreach efforts will cover a range of mediums: TV, radio, newspaper, outdoor, transit and digital, in English and Spanish.

 
Blue Cross Blue Shield launched its own, unbranded marketing campaign in April. “Be Covered Illinois,” available in both English and Spanish, is a campaign directed at increasing consumer education about how consumers can benefit from the Affordable Care Act.

 
“For people to really have an understanding and awareness of a topic, they must be exposed to it at least seven times,” said Mike Deering, director of public affairs at Blue Cross Blue Shield. “And with that in mind, more is better than less in this case.”

 
Deering said BCBS will have ample opportunity to promote its own healthcare plans once the marketplace opens. The Illinois Department of Insurance welcomed the idea of additional educational outreach because of the sheer size of the topic.

“We understand insurance is difficult and frankly intimidating,” said Deering. “We’re trying to make it as approachable as possible so people understand what’s in it for them.

In late August officials of California's exchange, the biggest of the state marketplaces, said there could be a possible delay in the opening of its state-facilitated marketplace. Shortly after, Oregon also announced that the opening of their state-run marketplace could be delayed a few weeks. State officials in Oregon said they wanted time to fix flaws before opening the exchange to the general public.

The Illinois Department of Insurance did not respond to requests for comment on the possibility of a delay in the state marketplace’s opening.