Illinois Senate Moves Towards Passing State Based Health Insurance Marketplace

In passing HB3227 (formerly SB34) today, the Illinois Senate took a major step in establishing a state based health insurance marketplace that helps small businesses and individuals in Illinois.

State Senator David Koehler (D-46 Peoria), chief sponsor of SB34 (now contained in HB3227) commented after the vote, "I am pleased that a super majority of my colleagues in the Senate voted for Illinois to establish its own state health insurance marketplace. Expanding help and providing a voice for small businesses and individuals who will be utilizing the new Illinois Health Insurance Marketplace is the intention of the Affordable Care Act, and I am proud that the Illinois Senate has made that commitment."

Brigid Leahy, Director of Legislation at Planned Parenthood of Illinois, said, "If we're running things at the state level, we can fix things, we can make them better, we have better control over making sure that it works for consumers. If it’s in the hands of the feds, we don’t have that power."

HB3227 establishes a pro-consumer and pro-small business health insurance marketplace in Illinois. The health insurance marketplace will be the one-stop insurance shop for more than a million Illinoisans.

Speaking on behalf of the Illinois Public Health Association, Tom Hughes said, "The diversity of this board will best represent the population of Illinois and protect consumers in the new marketplace."

HB3227 ensures that the marketplace is governed by a diverse board that represents women, small businesses, communities of color, labor, public health, people with disabilities, and consumers, and provides for accountability of the insurance industry selling plans on the new marketplace.

Jim Duffett, Executive Director of the Campaign for Better Health Care, said, "This historic vote by the Illinois Senate today shows the Senate's commitment to Illinois small businesses and individuals who will be eligible for the new Illinois health insurance marketplace. When fully implemented nearly 1.2 Illinoisans will be utilizing this marketplace. HB3227 will provide small businesses and consumers a direct voice in developing and implementation a State Based Marketplace that meets the needs of Illinoisans. Now it is up to the Illinois House to show their commitment and support to small businesses and individuals, and to President Obama's Affordable Care Act."

ADDENDUM
HB3227 Fact Sheet

Media Contacts:

Jim Duffett, CBHC Executive Director
217.352.5600 office / 217.840.5850 cell

Kathleen Duffy, CBHC Communications Director
312.913.9449 office / 773.934.4754 cell

The “Culture of Coverage:” How Illinois is making the Health Insurance Marketplace Work

On March 29th, Illinois submitted an outreach and enrollment plan to the federal government, a requirement for all states participating in a state-federal partnership health insurance exchange. In the proposal, the marketplace team explains that they plan to treat outreach and enrollment like a political campaign, working not to elect a candidate but instead to introduce a new “health culture” to Illinoisans who have traditionally been excluded from coverage. The campaign will launch full-force in July in order to address skepticism and the general lack of awareness around the Affordable Care Act before enrollment begins on October 1st of this year.

Campaign values:
Illinois faces a variety of challenges, including limited English proficiency and low literacy rates, which make the task of reaching and enrolling certain populations of residents difficult. 78% of uninsured adults and 83% of the Medicaid population are unaware of insurance options under the ACA. To insure that Illinois is successful in promoting awareness of the Affordable Care Act, the marketplace team’s work will be guided by the following principles:

1. Promotion of a State-wide Culture of Coverage; 
2. Empowerment of Community-Based Organizations and Stakeholders; 
3. Metric-Focused Encouragement of Enrollment; 
4. Promote Health Care as a Value; and 
5. Build a Strong and Trusted Reputation Among All Residents. 

Campaign strategy:
Based on the assumption that many Illinoisans aren’t aware of their options, the marketplace team will hire a professional marketing firm by the end of May. This firm will work to create a cohesive brand that speaks to target populations while establishing the Illinois marketplace as a trusted entity and something that residents will want to participate in. This media campaign will consist of television, print, outdoor, direct mail, online, and social media advertising.

The field program:
While the exchange branding is no doubt important, the marketplace team recognizes that empowering community partners to assist in the outreach and enrollment process may be the most effective way to achieve a “culture of coverage,” as these community partners are already known and trusted entities. This collaboration, titled the “field program,” will focus on the “4 E’s:” Engage, Empower, Educate, Enroll.

Staffing structure:  
Illinois will be divided into 8 “Outreach Regions,” which will be constructed geographically and by information around where the uninsured in Illinois reside. Each region will be headed by an Outreach Coordinator, who will report to the Director of Outreach & Consumer Education.

In order to assist with enrollment, three categories of assisters will be established. Similar training must be undergone in order to qualify for each category. The assister categories are as follows: 

1. Navigators: part of a federally-run assistance program 
2. In-Person Counselors: a state program that will coordinate with Regional Outreach Coordinators. Selected entities are expected to spend one year as assisters. 
3. Certified Application Counselors: Additional national funding for individuals who aren’t funded through grant money.

It’s coming…
The marketplace team is already working hard to make sure the health insurance marketplace works in Illinois. In the meantime, click here to check out the full Illinois Health Insurance Marketplace Outreach & Education Plan!

Kathryn Bailey
Health & Disability Advocates

Great News for the People of Illinois...Now What?

Yesterday, Governor Quinn announced that Illinois was awarded a $115 Million grant for its Health Insurance Marketplace (the online portal to enroll over a million adults and children into quality health plans). A large portion of this federal funding will pay for outreach activities and consumer assistance during the push to enroll the uninsured beginning on October 1 of this year.

This is great news for the people of Illinois.

With October 1 less than six months away, we need these federal funds to help get the word out about the availability of new insurance coverage options. According to Enroll America's research findings, the  majority  of  uninsured Americans  don’t  know the  health  reform  law  will  help  them:

• 78% of  the  uninsured  don’t  know  about  the new  health  insurance  exchanges  
• 83% of  people  who  could  be  eligible  for  the new  Medicaid  expansion  don’t  know about  it.  

Tremendous amount of work needs to get done to tell people about the new options and enroll them into a plan. 

Here's a timeline of what needs to happen to be ready by October 1, 2013. Since Illinois is running its exchange/marketplace in partnership with the federal government, we need to be mindful of activities by both the feds and the state:

Already Happened:

• Illinois Marketplace Team Selects Training Vendor (UIC/Public Health)
• Marketplace Team Releases Outreach & Education Plan & Conducts Outreach to Encourage Navigator & In Person Assister (IPA) Applications. (Read this fact sheet to learn about the different Consumer Assistance Entities needed).
• Marketplace Team Receives Establishment Grant Funding
• Illinois Marketplace Team Releases RFP for Media and Marketing Outreach Strategy.
• CMS Releases Proposed Standards for Navigators and In Person Assisters (see here for a good summary)
• Federal Government Releases Navigator RFP (Just released today, April 9, 2013; due June 7,
  2013; Expected Award Date - August 15, 2013). 
• Advocates create the Illinois Consumer Assistance Matchmaking Spreadsheet to find partners in either the federal Navigator grant or the (yet to be released) Illinois Assister RFP.

Spring 2013:

• Marketplace Team Issues RFP/Grant Application for IPA entities
• Marketplace Team Approves IPA Training Materials
• Marketplace Team selects firm for Media and Marketing Outreach Strategy (UPDATE: On 7/12/13 Fleishman Hillard is selected)

Summer 2013:

• Federal Government Selects Navigator Entities (Due date for application: June 7, 2013)
• Marketplace Team Selects IPA entities (see list here) 
• Federal Government Takes Applications for Certified Application Counselors (sign up here)
• Navigators, IPAs, Certified Application Counselors (CACs) Receive Training and Certification.
• Media placement begins

October 2013 and beyond:

• Navigators, IPAs & CACs Assist Consumers during Open Enrollment
• Navigators, IPAs & CACs Provide Post-Enrollment Assistance & Assistance during Special Enrollment Periods
• Program Oversight Conducted By Marketplace Team and Federal Gov’t.

The timeline is tight and we need all types of entities (community based organizations, hospitals, health departments etc.) to help with enrollment.

If you have any questions about  what this means for you or your organization, please don't hesitate to contact us at info@illinoishealthmatters.org.

Stephani Becker
IHM Project Director

The HHS Secretary Visits Chicago

This week, U.S. Health and Human Services Secretary Kathleen Sebelius visited Chicago to speak about the Illinois Health Insurance Marketplace, a key provision of the Affordable Care Act.

Secretary Sebelius, accompanied by Governor Pat Quinn, announced on Wednesday that the Illinois Blueprint Application for a State-Partnership health exchange had been accepted by the federal government. The exchange will run as a federal-state partnership model until 2015, when the state may take over operations, depending on the State Legislature’s ability to pass a state exchange bill. Enrollment in the partnership exchange/marketplace opens in October, only eight months (229 days!) away.

Secretary Sebelius speaks to a full house at the Chicago Cultural Center

On Thursday, Sec. Sebelius spoke at the Chicago Cultural Center. Preceding her was Bechara Choucair, Commissioner of the Chicago Department of Public Health, who presented an overview of the Healthy Chicago program and its impact thus far. Sebelius delivered a call to action to those in attendance, citing the need for affordable, accessible health insurance for all as a crucial step in the national public health strategy. With only eight months before the state health marketplace is open for enrollment, and ten months before it is fully operational, promoting awareness of the health insurance exchange is the focus of HHS. 

Navigators, Assisters, and Counselors, Oh My!

By now we know that upwards of 30 million Americans will have new, more affordable health coverage options available to them by January 1, 2014. But what many don’t realize is how incredibly difficult it can be to understand and choose the right health insurance on your own.

The Wizard of Oz’s Dorothy had guides along the way, and the Affordable Care Act (ACA) provides some as well – hopefully, with fewer pitfalls. But not everyone can counsel people about health insurance. There are complex public and private systems to navigate, and most people who will likely get insurance in the new Health Insurance Exchanges, or Marketplaces, will be more racially diverse, less educated, and earn lower income than people in private insurance now. Most will have a high school education or less, and as many as one in four speak a language other than English at home. So it matters that the people who guide consumers along the path to coverage are trusted members of the community and understand their circumstances.

Luckily, the ACA provides different options for guides along yellow brick road.

Navigators are outlined in the ACA as helpers for people to enroll in coverage through the Exchange, and refer or assist with Medicaid enrollment. Navigators are funded through Exchanges, and regulations from the Department of Health and Human Services (HHS) are clear that anyone who gets payments from insurance companies cannot be a Navigator. Navigators also must meet cultural competency standards and go through training and certification. States running their own Exchanges are developing Navigator programs now and must fund these with state Exchange dollars. For Federal Exchanges and Partnership Exchanges, HHS has said that it will fund Navigators directly through an upcoming RFP process. Be on the lookout for this announcement in the next few weeks.

To add even more help on the ground, HHS recently outlined in regulations another program,Assisters (or, In-Person Assistance). Like Navigators, Assisters must meet training and conflict of interest standards. They could fill in gaps in areas that need more enrollment assistance, or provide outreach and education about the ACA’s new options. Funding for Assisters is a key difference from Navigators. States running Exchanges or opting for the Consumer Assistance Partnership can apply for funds for Assisters through their Exchange Establishment grants. A number of states are applying now for these funds. Unfortunately, Assisters currently are not an option for Federal Exchanges.

And when you thought there were enough new health-related terms, HHS regulations added yet another helper to enroll people, Certified Application Counselors. Every Exchange must have a Certified Application Counselor program, with similar training and privacy standards as Navigators and Assisters. A difference in this program is that there is no funding mechanism. It is unclear who will serve this role – although the regulation suggests it could be community-based organizations or health care providers. Stay tuned for further clarification on this new option.

But even these multiple types of help will not be enough to spread the word about the ACA. Helping people understand and choose the right health plan, especially given the amount of misinformation in the media and elsewhere, is going to be a huge task. Nevertheless, these resources in the ACA provide a foundation to start building greater understanding of health care options to get people into the right coverage.

This post originally appeared on Health Policy Hub's the Community Catalyst Blog. 

Written by Christine Barber, Senior Policy Analyst

What is the Illinois Partnership Health Insurance Marketplace?

The Affordable Care Act requires each state to have a health insurance marketplace (otherwise known as a "health insurance exchange"). Originally, the plan was for each state to establish its own health insurance marketplace, or default to a federally-run exchange. After the ACA passed, the federal government offered a new “partnership exchange” model, which is to relieve some of the administrative burden on the state by providing federal assistance. Illinois sent the federal government a blueprint application in November 2012 to establish a state-federal partnership exchange in 2014, with plan to transition to a state based exchange after 2015. The state is waiting for final approval of the blueprint.

On January 3, 2013, the federal Center for Consumer Information and Insurance Oversight sent out guidance on how a partnership health insurance exchange will work. The guidance allows states like Illinois who plan to transition to a state based exchange to take on as much responsibility as possible for exchange activities such as administration, plan selection, and consumer assistance. This model is referred to as a State Plan Management Partnership Exchange.

A key role of a state exchange is to provide consumers assistance in enrolling in the exchange, understand their options for insurance coverage, make decisions about coverage, and coordinate with community based organizations. This consumer help will be provided by two programs, In-Person Assisters (IPA) and Navigators, which will be separate but closely coordinated. The Navigator program will be run by the Federal government, and Illinois will develop the IPA program. Since Illinois has historic connections in the community and their understanding of the state-specific insurance, Medicaid and supplemental state health programs, the IPA program will be the primary contact for consumers and for insurance companies.

Community Based Organizations, consumer assistance organizations, medical and social service providers will all play an important role in ensuring that the Illinois state federal partnership exchange is efficient and accessible. Consumer advocates should work cooperatively with the state and federal governments to ensure that whichever agencies are responsible for administering parts of the exchange, that the end result is a coordinated system that works well for the people who need insurance coverage, including the small employers who need to purchase insurance for their employees.

Stephanie Altman
Programs & Policy Director
Health & Disability Advocates