IHA Daily Briefing: Nov. 7

Election Results Recap
ACA Decreased ED Uninsured Patient Visits in IL
Study: Excluding Pre-Existing Conditions Costly

Election Results Recap
While the national media debates whether a “Blue Wave” occurred last night, there is no doubt about its impact in Illinois. Democrats won every statewide constitutional office and two additional Congressional seats. Illinois voters gave Democrats a veto-proof supermajority in the Illinois House (72-45, with one race still too close to call) and expanded the supermajority for Democrats in the Senate (39-18, with one race still too close to call).

Democrats will hold all statewide constitutional offices for the first time since 2010. Democrat J.B. Pritzker defeated Republican Gov. Bruce Rauner by more than 14 points, the worst defeat of an incumbent governor in Illinois in 70 years. In other statewide races, State Senator Kwame Raoul of Chicago defeated Erika Harold of Champaign County in the open race for Attorney General, and Susana Mendoza won re-election for Comptroller over Darlene Senger. Incumbents Secretary of State Jesse White and State Treasurer Mike Frerichs also won their races.

In races for Congress, Republicans maintained and expanded their majority control in the Senate (52-43-2, with three races yet to be decided), while Democrats took back control of the House (222-199, with 14 races still open) for the first time since 2010.

Political observers closely watched four contested races in Illinois congressional districts now held by Republicans. Democrats Sean Casten and Lauren Underwood defeated incumbent Congressmen Peter Roskam and Randy Hultgren respectively in the northeastern collar counties. Congressman Rodney Davis escaped with a victory over Democratic challenger Betsy Dirksen Londrigan in Central Illinois, and Congressman Mike Bost defeated his Democratic challenger Brendan Kelly in Southern Illinois. Democrats will hold a 13-5 edge in the Illinois congressional delegation.

The trends at the top of the ticket also worked to the advantage for Democrats down the ballot in Illinois.  A few highlights include:

  • State Republican Party Chairman Tim Schneider was defeated in his re-election for Cook County Commissioner by Kevin Morrison. Republican Commissioner Greg Goslin was defeated by Scott Britton. There are now just two Republicans on the Cook County Board;
  • While DuPage County Board Chairman Dan Cronin was elected to his third term, Democrats picked up two county board seats and elected Jean Kaczmarek as County Clerk;
  • Democrats picked up seats in the County Boards in Lake and Kane, and took control of the County Board in Will; and
  • Democrats swept countywide races in Champaign County.

See IHA’s summary memo for more details about last night’s election results.

ACA Decreased ED Uninsured Patient Visits in IL
A study on the impact of the Affordable Care Act (ACA) and emergency department (ED) visits by uninsured patients in Illinois showed a reduction in visits between 2009 and 2015. Using Healthcare Cost and Utilization Project data, researchers determined that there were more than 31 million emergency department visits in Illinois from 2009-2015, with 4.1 million visits by uninsured patients. When comparing pre-ACA with post-ACA data, researchers found that there was a 40 percent reduction in uninsured patient visits to the emergency department.

The authors concluded that while the ACA and Medicaid expansion in Illinois contributed to the decline in uncompensated care in emergency department visits, more studies are needed to quantify the overall effects of the ACA related to health disparities, regional trends, etc.

The study was presented last week at a national conference. The abstract can be found on page 39.

Study: Excluding Pre-Existing Conditions Costly
A Commonwealth Fund study released this month found that if insurance companies were allowed to exclude pre-existing conditions from health insurance coverage it could cost consumers with asthma, arthritis, cancer, diabetes, and high blood pressure thousands of dollars in increased out-of-pocket costs.

Coverage for pre-existing health conditions, which is guaranteed under the Affordable Care Act (ACA), is currently threatened by the Texas v. Azar lawsuit. If successful, the suit would invalidate the ACA along with its requirement that insurers cover preexisting conditions. A Republican-backed Senate bill, the Ensuring Coverage for Patients with Pre-Existing Conditions Act, seeks to ensure that people with pre-existing conditions could still buy health insurance coverage, but, unlike the ACA, the bill does not require that health plans cover treatment for these conditions.

In the new report, How Would Americans’ Out-of-Pocket Costs Change If Insurance Plans Were Allowed to Exclude Coverage for Preexisting Conditions?, the authors detailed how consumers would fare under the proposed legislation compared to current coverage under the ACA. The authors found that:

  • The average annual out-of-pocket spending for consumers is projected to increase by $260 for high blood pressure, $370 for asthma,$450 for arthritis,$2,370 for cancer, and $2,520 for diabetes. People with cancer or diabetes could see their out-of-pocket spending triple; and
  • People with the most severe illnesses of each type would face the biggest out-of-pocket spending increases. For the10 percent of people with the highest costs, annual out-of-pocket spending would exceed $4,900 for cancer patients and $9,200 for diabetes patients.