Illinois residents who want to learn more about Affordable Care,
explore their options in the Exchange or need assistance in signing
up for a health plan can find a one-stop shop at
Parents in Chicago also can find assistance at their child's
public school, which has a healthcare counselor on site at every
Chicago Public School. Illinois has opted to use the federal site
instead of creating its own.
In addition to Affordable Care, Illinois has a host of state
options to provide health insurance cost-savings for children. For
more information, visit health.illinois.gov/parentorchild.html.
As the national debate continues to rage, key provisions of the
Patient Protection and Affordable Care Act are poised to take
center stage with the enrollment of individuals and families in the
new Health Insurance Marketplace.
Beginning Oct. 1, a robust group of insurance companies will
begin shopping their qualified health plans to the public under the
provisions of Affordable Care, which is known more popularly as
Of particular interest for those companies will be attracting
potential policyholders among Illinois' 955,000 residents who need
insurance and have a full-time worker in the family.
It is believed that population will be able to afford coverage
under the scaled-back pricing required in the Health Insurance
Marketplace, which will be known as the Exchange.
The U.S. Department of Health and Human Services estimates
nearly 1.3 million Illinois residents who are uninsured and
eligible may qualify for lower costs on coverage in the Exchange,
including through Medicaid.
Barbara Otto, CEO of Chicago-based Health & Disability
Advocates, expects the greatest beneficiaries in the near term will
be those who live at-or below-138 percent of the federal poverty
That includes a vast pool of families whose annual household
income is $32,000 or less per year. Collectively, this group has
not been able to qualify for Medicaid and found health insurance to
be an unaffordable luxury.
In the longer term, Otto says every payer group will be
positively impacted by the new law. Those who have insurance will
have more choices and stronger coverage. The uninsured, as well as
families and small business owners who buy their coverage but
aren't happy with it, will have new options.
HHS statisticians have already begun quantifying the positives
of the new law by demographic group and estimate there is a benefit
for every individual and family, whether that means increased
coverage or a better value for their healthcare dollar.
"We were fortunate in Illinois that the process of providing
insurance, especially for children and families, started before the
Affordable Care Act became law," says Otto, who advocates for
access to essential health services and support for vulnerable
populations and has lobbied on the national stage for health care
reform. "Despite those best efforts to provide health insurance for
all Illinois children, there are still 40,000 children under age 19
in Cook County who do not have coverage."
The government and Affordable Care advocates acknowledge there
will be challenges in helping the public understand the new system,
as well as its options and benefits, but point to a bevy of
resources that are available, as well as a 24/7 national help line,
which has been created to assist people as they navigate the new
U.S. Health and Human Services touts that there is something for
everybody contained in the Patient Protection and Affordable Care
Those who have no health insurance today
The uninsured will have an insurance marketplace to tap into
that will make it easier to compare competing health plans and get
answers. The marketplace, which will be known officially as the
Exchange, will help individuals and families learn if they are
eligible for lower cost private insurance or existing state-run
health programs, such as Medicaid and the Children's Health
Insurance Program. It will assist them in enrolling for
Coverage for young adults
Affordable Care requires a parent's insurance to extend coverage
until their 26th birthday.
Eliminating discrimination for pre-existing
Today, insurers are forbidden from denying coverage to children
because of a pre-existing condition, such as asthma or diabetes.
Beginning in 2014, that same protection is extended to all age
groups. A temporary health insurance program is being established
for individuals who have been denied health insurance coverage in
Increasing the value of your insurance
The 80/20 rule: Insurance companies have to spend at least 80
cents of every premium dollar paid on healthcare or improvements to
care or refund the difference to you. Illinois families are
expected to receive an average refund of $52 this year as a
Controlling premium increases
Insurance companies must now publicly disclose how they are
going to spend premium increases of 10 percent or more. Since the
law was implemented, the percentage of companies requesting such
increases have dropped from 75 percent to 14 percent. American
consumers have already saved an estimated $1 billion.
Eliminating lifetime limits
Cancer survivors and others who have been treated for chronic
diseases no longer have to worry about exceeding the lifetime
limits on their policies. The law currently restricts the use of
annual limits and bans them beginning in 2014.
Eliminating co-pays for preventive services
Affordable Care requires many insurance plans to provide
coverage without out-of-pocket costs for preventive screenings,
such as colonoscopy, mammograms, Pap smears, well-child visits and
flu shots. This benefit has been extended to Medicare patients.
Increasing affordability for prescription drugs for
Coverage for both brand name and generic drugs will continue to
increase until the coverage gap is closed. Since the law went into
effect, seniors have saved more than $7 billion on drugs.
Protecting the system
Affordable Care extends the life of the Medicare Trust Fund by a
decade and increases fraud protection. Since 2009, fraud
enforcement efforts have recovered $14.9 billion.
See more of Robin's stories here.
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