Illinois Gov. Pat Quinn on Thursday hailed the U.S. Supreme Court decision upholding key provisions of President Barack Obama's health care overhaul and said he now will look to the state Legislature to pass a law establishing an online health insurance marketplace.
The governor did not rule out the possibility of issuing an executive order to establish an exchange, an important part of the law's requirement that almost every individual have insurance.
"This is a great victory day for health care in our state and in our country," Quinn said at a news conference where he signed three health-care related bills into law, including one that will allow small businesses to form health care purchasing groups.
And senior U.S. Sen. Dick Durbin said the ruling on Obama's Affordable Care Act will enable the country to "address the unsustainable increase in health care costs" by expanding insurance coverage.
But other leaders weren't so thrilled.
State Sen. Bill Brady, a Bloomington Republican who co-chaired a state legislative study committee on the exchange, said the ruling "will have tragic consequences that will ... drive up health care costs and put yet another financial burden on our already struggling small businesses" and that the state will look for ways to implement the law while "providing the greatest options and lowest cost for our families and businesses."
Republican U.S. Sen. Mark Kirk said the law threatens the country's economic recovery and said Congress should repeal it.
Several physician and health care organizations, including the Illinois Hospital Association, praised the court's decision. The IHA said expanding coverage and eliminating exclusions for pre-existing conditions means "people in Illinois will no longer have a diminished quality of life, be at risk of dying merely because they lack health insurance or be forced into bankruptcy because of a devastating diagnosis."
The new Internet-based markets are supposed to provide one-stop shopping for health insurance, steering middle-class households to private plans and low-income people to an expanded version of Medicaid, the federal-state program for the poor and disabled.
States have the option of running their own exchanges, but the federal government offered the possibility of a state-federal partnership that will make it easier for slower states to catch up.
Quinn acknowledged what insurance industry officials and some state lawmakers have said — Illinois will need federal help to set up the exchange because it won't be able to submit its plans by the Nov. 16 deadline. While the state has received three federal grants totaling $39 million to study and start building an exchange, the Legislature failed to pass a law required to establish it, partly because many wanted to wait for the Supreme Court decision.
State Rep. Frank Mautino, a Spring Valley Democrat who has led work on implementing the exchange, told The Associated Press this week that it's too late for Illinois to do it on its own.
Thursday's decision added a wrinkle to the law, giving states more leeway to turn down the expansion of Medicaid. Under the law, the federal government will pick up all of the cost for the first three years, eventually dropping to a 90 percent share.
Quinn said Illinois plans to implement the Medicaid coverage as called for, and said doing otherwise was not a wise policy.
"We want everybody in, nobody left out when it comes to decent health care coverage," Quinn said.
His administration has estimated that, under the expansion, about 800,000 now-uninsured residents would get public or private health insurance, including about 500,000 — many childless adults — who would become eligible for Medicaid. The law calls for states to provide Medicaid coverage for adults with incomes of up to 133 percent of the federal poverty guidelines, but Illinois has been far more generous for parents and has taken steps to pare its Medicaid rolls.
At its peak, the Illinois Family Care program, a favorite of imprisoned former Gov. Rod Blagojevich, covered parents with incomes up to 400 percent of the federal poverty guidelines, or $60,500 for a two-person household.
After July 1, Illinois will only cover the neediest parents with household incomes up to 133 percent of federal poverty guidelines, or about $20,100 for a two-person family — throwing more than 25,000 working parents out of the program as part of a $1.6 billion Medicaid spending cut.
Open enrollment for millions of now-uninsured Americans is scheduled to begin in October 2013. Those who have insurance won't have to worry about the loss of popular benefits, such as coverage for children until age 26 or improvements to Medicare's prescription plan.
And, starting in 2014, insurance companies will no longer be able to turn away people with a history of medical problems, or charge them more. Seniors also stand to receive better Medicare coverage and no copayments for preventive care.