Il. Commission Votes to Suspend Open Access Plans for State Employees

(With additional reporting from Illinois Public Radio)

The state agency in charge of health insurance for public employees says it is going forward with a plan to drop Health Alliance HMO and Humana as options for state and university employees' medical insurance.

Urbana-based Health Alliance and Humana have protested the move.

The state's decision comes in spite of a vote Wednesday morning by the bipartisan Commission on Governmental Forecasting and Accountability (CGFA) to end self-insured/Open Access Plans for state employees, which is what the state planned to move employees to in areas where the HMO/Blue Cross Blue Shield plan isn't available. The vote potentially sets up a constitutional clash over the fate of health insurance for about 100,000 state and university workers.

Moving many employees to this sort of plan is how Governor Pat Quinn's administration had been planning to save up to $100 million a year.

Attorney General Lisa Madigan issued a ruling last week stating that legislators don't have the power to interfere with specific contracts. However, despite Madigan's ruling, State Senator and CGFA member Mike Frerichs (D-Champaign) said the commission has the authority to weigh in on policy changes. He also noted that the commission's vote reflects a major policy shift in self-insurance at the state level.

"And that's something we have consent power over," Frerichs said. "We don't have the ability to consent to individual contracts, but this big policy shift we do. We rejected that, and I think that will necessitate rebidding of the whole package."

State Senator Matt Murphy (R-Palatine) also sits on the commission. He said the vote by CGFA was done as an attempt to get all parties back to the bargaining table.

"My hope is that everybody involved in this process, rather than rush into court and having lawsuits, can all sit down together and try and perhaps try and rebid it, come up with a different plan," Murphy said.

It is unclear if the commission's vote is binding, and could send matters into a tailspin. The Department of Healthcare and Family Services is going forward as if that vote was insignificant.

"We followed the letter of the law," DHFS spokeswoman Stacey Solano said. "Everything was done fairly, it was done ethically, so why would we reopen the bidding?"

Downstate legislators have been highly critical of the decision to drop Health Alliance. They have shown no signs of letting down.

Meanwhile, many of the employees and retirees with Health Alliance as medical insurance say they don't want a new provider because they fear they will be forced to switch doctors. They are also concerned they will pay more out of pocket on doctor's visits.

As it stands now, state employees have until June 17 to decide what provider they want for medical coverage. The state is also considering opening another enrollment period this fall.