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Supreme Court Maintains the ACA 5-4 and RetainsThe Individual Mandate

Health & Medicine Policy Research Group (HMPRG)
June 28, 2012

Download What the ruling means to people in Illinois

What the ruling means to people in Illinois:

How the Health Care Law is Making a Difference for the People of Illinois

The new health care law improves access to health care for over one million Illinoisans and Illinois small businesses.  Health reform is already making a difference for the people of Illinois by:

Providing new coverage options for young adults
Health plans are now required to allow parents to keep their children under age 26 without job-based coverage on their family coverage, and, thanks to this provision, 3.1 million young people have gained coverage nationwide. As of December 2011, 125,000 young adults in Illinois gained insurance coverage as a result of the health care law. For more details on these numbers, visit here.

Making prescription drugs affordable for seniors
Thanks to the new health care law, 152,170 people with Medicare in Illinois received a $250 rebate to help cover the cost of their prescription drugs when they hit the donut hole in 2010. Since the law was enacted, Illinois residents with Medicare have saved a total of $155,851,726 on their prescription drugs. In the first five months of 2012, 26,332 people with Medicare received a 50 percent discount on their covered brand-name prescription drugs when they hit the donut hole. This discount has resulted in an average savings of $636 per person, and a total savings of $16,756,840 in Illinois. By 2020, the law will close the donut hole.

Covering preventive services with no deductible or co-pay
In 2011, 1,353,031 people with Medicare in Illinois received free preventive services – such as mammograms and colonoscopies – or a free annual wellness visit with their doctor. And in the first five months of 2012, 665,852 people with Medicare received free preventive services. Because of the law, 54 million Americans with private health insurance gained preventive service coverage with no cost-sharing, including 2,390,000 in Illinois.

Providing better value for your premium dollar through the 80/20 Rule
Under the new health care law, insurance companies must provide consumers greater value by spending generally at least 80 percent of premium dollars on health care and quality improvements instead of overhead, executive salaries or marketing. If they don’t, they must provide consumers a rebate or reduce premiums. This means that 299,544 Illinois residents with private insurance coverage will benefit from $61,802,411 in rebates from insurance companies this summer. These rebates will average $380 for the 163,000 families in Illinois covered by a policy.

Scrutinizing unreasonable premium increases
In every State and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Illinois has received $4.5 million under the new law to help fight unreasonable premium increases.

Removing lifetime limits on health benefits
The law bans insurance companies from imposing lifetime dollar limits on health benefits – freeing cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment because of their lifetime limits. Already, 4,670,000 residents, including 1,743,000 women and 1,192,000 children, are free from worrying about lifetime limits on coverage. The law also restricts the use of annual limits and bans them completely in 2014.

Creating new coverage options for individuals with pre-existing conditions
As of April 2012, 2,384 previously uninsured residents of Illinois who were locked out of the coverage system because of a pre-existing condition are now insured through a new Pre-Existing Condition Insurance Plan that was created under the new health reform law. To learn more about the plan available in Illinois, check here.

Supporting Illinois’s work on Affordable Insurance Exchanges
Illinois has received $6.2 million in grants for research, planning, information technology development, and implementation of Affordable Insurance Exchanges.

  • $1 million in Planning Grants:  This grant provides Illinois the resources needed to conduct the research and planning necessary to build a better health insurance marketplace and determine how its exchange will be operated and governed. Learn how the funds are being used in Illinois here
  • $5.2 million in Exchange Establishment Grants:  These grants are helping States continue their work to implement key provisions of the Affordable Care Act. Learn how the funds are being used in Illinois here.

Preventing illness and promoting health
Since 2010, Illinois has received $31 million in grants from the Prevention and Public Health Fund created by the Affordable Care Act. This new fund was created to support effective policies in Illinois, its communities, and nationwide so that all Americans can lead longer, more productive lives.

Increasing support for community health center
The Affordable Care Act increases the funding available to community health centers in all 50 states, including the 537 existing community health centers in Illinois. Health centers in Illinois have received $118.3 million to create new health center sites in medically underserved areas, enable health centers to increase the number of patients served, expand preventive and primary health care services, and/or support major construction and renovation projects

Strengthening partnerships with Illinois
The law gives states support for their work to build the health care workforce, crack down on fraud, and support public health.  Examples of Affordable Care Act grants to Illinois not outlined above include:

$10.3 million for Maternal, Infant, and Early Childhood Home Visiting Programs. These programs bring health professionals to meet with at-risk families in their homes and connect families to the kinds of help that can make a real difference in a child’s health, development, and ability to learn - such as health care, early education, parenting skills, child abuse prevention.

By Citizen Action Illinois