When Governor-elect JB Pritzker and incoming legislators take office a few days from now, we hope among the top-of-mind issues for them will be healthcare – and the possibility of creating a public option that would allow Illinois residents to purchase a premium to participate in the state’s Medicaid program. Candidate JB Pritzker talked about his vision for such an initiative, which he called “IllinoisCares,” and his platform included a public health insurance option that would be available to all residents.
IllinoisCares would allow Illinois residents to purchase health insurance from the state, rather than a commercial plan. Forty-two states – including Illinois – already have Medicaid buy-in programs, but they are limited to working people with disabilities who have not been able to purchase affordable health insurance coverage that meets their health needs in the private market. The public option was a feature of early drafts of what became Obamacare, but it did not make it into the final law.
In 2018 there was a lot of debate about “Medicare for all,” another incarnation of the public option concept. Unlike Medicare, however, Medicaid is essentially a state program, and has more-comprehensive coverage than Medicare, including things like comprehensive habilitation and rehabilitation services and allowing states to negotiate drug prices. As a result, a public option built off of a state’s Medicaid program is seen by some as a better option for people and payers.
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