This is a rebuttal to a piece entitled “Health care coverage threats” published in the Northwest Herald on May 14, 2020. This “letter to the editor” improperly maligns Illinois 6th district candidate for U.S. congress, Jeanne Ives by inaccurately describing her position on health care reform. It also incorrectly describes how medical risk was mitigated prior to A.C.A. (Obamacare) implementation and how Republicans plan to control that risk going forward. These inaccurate statements need to be corrected, publicly. I submitted this rebuttal to the Northwest Herald on May 15, 2020 and as of today, the Northwest Herald has not published my rebuttal.
The aforementioned letter to the editor incorrectly refers to state based high risk health insurance pools as providing “uniformly dismal results, plagued by under-funding, high premiums and deductibles, long waiting periods and enrollment caps”.
If those statements were true our state based high risk health insurance pool known as “I.C.H.I.P” – Illinois Comprehensive Health Insurance Plan – would not still be in operation today, but it is. It is still in operation because our House Speaker, Michael Madigan has requested that it stay in operation. This is because I.C.H.I.P. policies (insured by Blue Cross Blue Shield) offer premiums that are commensurate or less than those offered to unsubsidized applicants who purchase A.C.A.-qualified (Obamacare) policies via Healthcare.gov. I.C.H.I.P. policies also expose the policyholder to lower out of pocket expenses and better access. I.C.H.I.P policies include in network P.P.O. access to our Teaching hospitals in Chicago like the University of Chicago hospital, Rush university medical center and Lurie Children’s hospital.
There are no individual ACA-qualified policies available in Chicagoland that include access to those Teaching hospitals. In fact, the only individual A.C.A.-qualified P.P.O. plans that are still available in Chicagoland are the Blue Choice Preferred PPO plans from Blue Cross Blue Shield of Illinois. However, even those plans are not accepted at any of the Northshore hospitals or any of the Advocate hospitals. For access to those hospitals, you must purchase an H.M.O. That is not the case with I.C.H.I.P. policies. They are accepted at all of our Teaching hospitals and many other hospitals around Illinois and around our nation.
Secondly, the concept of separating and subsidizing those with the largest medical claims from those who are healthy has been proven to work time and time again. Doing so is how 45 states (including Illinois) kept individual health insurance premiums at an affordable rate long before the A.C.A. Back when individual health insurance premiums were 200% lower than they are today. Back when we had 168 more health insurers offering individual health insurance products than we have today.
It is also how states are once again substantially reducing individual marketplace premiums today. In 2017 Alaska was granted a 1332 waiver from the stringent requirements of the A.C.A. which allowed them to reestablish their own reinsurance risk pool. Before Alaska’s 1332 waiver was granted, individual marketplace premiums were projected to increase by another 42%. Afterwards, Alaska regulators were able to reduce those increases to only 7.3%.
This is why Families U.S.A. has stated that these concepts “can work”.
It is also why 34 other states have filed for a 1332 waiver since 2018.
Lastly, I want to address the “long waiting periods”. There are no waiting periods under our current I.C.H.I.P. program and there were no waiting periods under our I.C.H.I.P. program before the A.C.A. so long as the applicant was H.I.P.A.A eligible. H.I.P.A.A. eligible applicants are those who can demonstrate that they have maintained existing health insurance coverage for at least 18 months, with no lapse in coverage of more than 63 days. The only “waiting period” that ever existed under I.C.H.I.P. applied to those who did not maintain consistent health insurance coverage and chose instead to wait to purchase health insurance until they needed it. Those kinds of applicants must wait until January 1st to obtain individual health insurance under current A.C.A. rules. Just as they were required to wait under I.C.H.I.P. long before the A.C.A. became the law of the land.
They must wait today and they were made to wait then because those who wait to purchase health insurance until they are sick have been proven to drive up the cost of health insurance for everyone else.