Questions and Answers About Illinois Covered

Any new and ambitious plan that addresses the current health care crisis in Illinois is bound to raise questions from politicians, the press, and the general public. Below are commonly asked questions about Illinois Covered and appropriate responses that clarify portions of the policy while keeping the focus on the importance of providing health care for all.

Q: Is the health care plan too expensive?

A: No. There is no cheaper way to do health care reform in a respectable way. To accomplish this important task, we must recognize the cost and forthrightly pay for it.

The program will save money or at least break even over time. Recent research from Emory University shows that if we make no changes in the current system, it will cost all of us $30 billion over the next 10 years in increased premiums and uncompensated care. The reform will avoid these costs and “rearrange” health care spending in a fairer and smarter way than the current system.

Q: How do we pay for it?

A: Gov. Rod Blagojevich proposes a Gross Receipts Tax (GRT), which imposes a low tax on all business receipts (with various exemptions). The GRT has two virtues: it produces the necessary money, and it will expand with the economy, so it is a sustainable source of funds for health care. If there are other sources of revenue that can get this job done, we are open to that.

To the extent the GRT may be passed through to consumers, this can be offset through a family tax credit or an expanded state earned income tax credit or both. But low-income and middle-income people understand that they must bear part of the burden of paying for health care for all, and they are willing to do so.

Q: Isn’t the additional “employer assessment” just another business tax?

A: The employer assessment is a way to make sure that all employers contribute to the healthier workforce. Those already providing health coverage for employees will not pay the assessment. Only those currently making little or no effort to cover employees will pay it. This levels the playing field among businesses while helping pay for the solution.

Q: Shouldn’t we make sure Medicaid is working properly before we even think about expansions?

A: The main thing wrong with Medicaid is that it does not have enough funding. The governor’s plan devotes money to fix parts of that blocked revenue stream for Medicaid.

The question also confuses Medicaid with the wider issues of health coverage. Most of the people who care deeply about this never have been and never will be covered by Medicaid. They are the people who have insurance and are worried about losing it, and worried about the cost of care even though they have insurance. They are the working middle-class people without insurance, or with paper-thin coverage. Everyone benefits when we have health care for all because premium increases are controlled, and everyone has an affordable option if everyone’s own insurance becomes too costly or disappears.

Q: The governor says his plan will cover only 500,000 of the 1.4 million uninsured, so it’s not even universal health care, is it?

A: The plan offers affordable, decent health coverage to everyone regardless of income. The 500,000 is the estimate of how many people will initially enroll.

Q: Well, would you support requiring everyone to enroll (an individual mandate)?

A: Our understanding is that the governor’s office is open to this but wants to see how voluntary enrollment goes first and make sure the program is truly affordable before mandating people to buy into it. If the insurance is truly affordable, we would be open to an individual mandate if there is a good reason for it.

Q: Explain to me how the governor’s plan covers everyone?

A: It expands public insurance to cover the poorest of the poor, and it offers a variety of subsidies and reforms to make private insurance affordable on a sliding scale to everyone else. I cannot give you more details than that, but I can arrange for an expert to answer any question.

Q: Isn’t this just Canadian socialized medicine?

A: No. It embraces the employer-sponsored and private insurance system. That system has been failing. It is responsible for the current mess that has everyone so angry and fearful. The governor’s plan applies key public investments and reforms necessary to make that system work. The plan is a uniquely American public-private solution.

Q: Isn’t this just too complicated? How can it ever work?

A: Sure, it’s complicated, but so is any large program. The basic concepts are easy enough—affordable decent health coverage for all.

—John Bouman, President, Sargent Shriver National Center on Poverty Law, johnbouman@povertylaw.org