Illinois lawmakers should create a state-based health insurance exchange and consider renting certain functions of HealthCare.gov if the U.S. Supreme Court rules against federal subsidies in states that haven't set up their own marketplaces.
The Illinois Hospital Association floated the ideas this month in a memo that stated, “If the Court rules that subsidies are not available … approximately 250,000 Illinoisans are likely to lose tax credits, jeopardizing their ability to obtain health insurance.”
Establishing an Illinois exchange could be less expensive now than in 2012, when a consulting group estimated it would cost $57.4 million to $88.6 million. That's because the state already has created several exchange functions. They include ensuring Illinois plans sold through HealthCare.gov meet certain requirements, such as covering hospital stays and prescription drugs.
But Illinois would need to pay for key pieces the federal government now performs, such as determining if consumers are eligible for subsidies. Given the state's deep budget deficit, funding any expanded program would be politically difficult. —Kristen Schorsch, Crain's Chicago Business