The state-level exchanges are intended to satisfy two key requirements of the federal law. They would be markets where individuals and small employers could satisfy the mandate to buy insurance, but the law would also guarantee that insurance companies would sell policies to most people who apply.
As of Aug. 1, 16 states have established exchanges through legislation or executive order. Because the Illinois General Assembly has not passed legislation to establish an exchange and Gov. Patrick Quinn has not established an outline for one through executive order, Illinois' exchange will be run jointly by the state and federal governments starting Jan. 1, 2014.
About 337,000 people are expected to buy health insurance through the exchange in 2014, according to documents from the Illinois Department of Procurement. That number is projected to climb to 489,000 in 2015.
By setting up a jointly run exchange, the state is doing “a two-step dance,” preparing for its eventual transition to a state-run exchange on Jan. 1, 2015, said Jim Duffett, executive director of the Campaign for Better Health Care in Champaign.
“They're doing it to get the ball rolling,” he said.
The federal government has given $39 million to start the exchange, said a state spokesman, with another $90 million possible. Most of the initial payment will go toward developing the exchange's computer infrastructure.
But if the Legislature fails to pass a bill establishing the exchange by spring, the insurance department is unlikely to extend the federal-state partnership on the exchange another year, said Laura Minzer, executive director of the Illinois Chamber of Commerce's Healthcare Council.
“They will simply say to the federal government, 'Come in,'” she said.