Fewer Illinoisans enrolled in insurance plans offered through the marketplaces established by the Affordable Care Act as costs increased and lawmakers eliminated the penalty for not having coverage.
Nearly 7 percent fewer Illinoisans enrolled in Affordable Care Act plans this year than last, according to a Chicago Tribune report. Enrollment also declined nationally, by about 3 percent on average.
In 2017, there were 334,979 consumers in Illinois who selected an exchange plan, numbers from the federal government show. In 2018, there were 312,280, a decline of 6.77 percent.
Goldwater Institute’s Director of Healthcare Policy Naomi Lopez Bauman said part of that has to do with the elimination of the federal penalty for not having health insurance coverage. Another factor is the increasing cost of health insurance coverage.
U.S. Rep. Rodney Davis, R-Taylorville, said insurance costs have gone up 108 percent since 2013 as competition has declined in most areas of Illinois where there are one and two providers.
“More Americans and more Illinois are choosing to not buy insurance [which] I think has less to do with what happens in Springfield and Washington and more about what happens with their own pocketbook and how they fit the healthcare cost and coverage that is exponentially rising into the family budget,” Davis said.
Bauman said everyone wants more affordable health insurance.
“And you don’t do that by limiting options. You do that by expanding options, by making sure that there’s a wide variety of products and services to choose from,” Bauman said.
Bauman said the Illinois legislature has limited choice instead of expanding choice.
Last year, state lawmakers overrode then-Gov. Bruce Rauner’s veto of a measure that limits short-term policies to just six months, rather than other policy durations President Donald Trump's administration enacted in 2018.
Bauman said Illinois lawmakers' decision to eliminate choices wasn't going to help. Gov. J.B. Pritzker's plan to let people buy into Medicaid also won't help longterm, she said.
“The idea that Illinois is basically curtailing options for Illinois citizens in terms of types of coverage they can get, but then they can get a government plan, this is in the opposite direction of where we should be heading,” Bauman said.
Bauman said Illinois already has a problem reimbursing Medicaid providers and providers are declining to take Medicaid patients.
Pritzker’s Medicaid plan has yet to materialize at the state capitol.
As for the debate in Washington, U.S. Rep. Bill Foster, D-Naperville, said in a statement that said Republicans have failed to live up to their promises on health care.
“All that President [Donald] Trump could deliver was a relentless campaign of sabotage that threatens the health care of millions of American families,” the statement said.
Davis said before Democrats took over the House, Republicans were able to do things to lower costs, and to offer more choices through different duration plans and association health plans.
“We have yet to see a plan out of any of the freshman Democrats except for some of the far left Democrats who are proposing this Medicare for all which would be trillions upon trillions in costs for the American people and take away private insurance as we know it,” Davis said.
“Congress must work to strengthen the ACA and not entertain empty, partisan attacks on life-saving health care,” Foster said.
And if the courts find the ACA unconstitutional, with one case pending, Bauman said judges likely wouldn't make any significant changes happen overnight.
Bauman said even if the courts were to strike down Obamacare as unconstitutional, they would likely give congress time to work something out before coverage would be impacted.
“The path forward is very unclear,” Bauman said. “You have Democratic control of the House and Republican control of the Senate so getting something across the finish line, some kind of alternative, is going to be incredibly difficult.”