Buying Health Insurance in Illinois: The Other Item on Your New Year Wish List

Jennifer Koehler J.D. is Executive Director of GetCoveredIllinois, the Illinois Health Insurance Marketplace. As Executive Director, she is responsible for the implementation and operation of all aspects of the health insurance marketplace for the State of Illinois, including all personnel, budget, procurement, and grant-making decisions. Prior to this role, she served as the Chief of Staff in Governor Pat Quinn’s Office of Legislative Affairs, where she assisted the Legislative Director in advancing Governor Quinn’s legislative agenda and budgetary priorities and interacted with members of the General Assembly on behalf of the administration.

As Executive Director of GetCoveredIllinois, what steps have you taken to implement a major component of the Affordable Care Act (ACA) in Illinois?

When I started in January the marketplace had 5 staff members, no marketing budget, no training budget, no consumer assistance budget, and no call center budget. Between January and October of last year, we brought $115 million in federal funds in the door. We competitively granted out a little over $27 million to 44 community-based organizations throughout the state to do consumer assistance. We also developed a three-day training program for all of those community-based organizations with the University of Illinois-Chicago (UIC), developed a certification process for Navigators with the Illinois Department of Insurance, and set up a landing page – GetCoveredIllinois.gov – with a screening tool that allows people to figure out whether they are Medicaid- or Marketplace-eligible. Finally, we’ve set up a Get Covered Illinois help desk, also colloquially called a call center, to get people to the right place—either the Illinois Medicaid application or the marketplace – and to answer state-specific questions about the plans and the new healthcare options that are available to Illinois consumers.

We managed to get all of that done in less than 10 months and had a successful October 1 rollout. Without knowing which agencies are best at doing what, and how to maneuver through state government and bureaucracy, I think that it would have been an almost insurmountable task to finish on time.

How have GetCoveredIllinois and your role as Executive Director fit into the larger network of ACA implementation and existing state-run public insurance programs in Illinois?

We work very closely with the Illinois Department of Healthcare and Family Services (HFS) and Illinois Department of Human Services (DHS). For example, our screening tool was developed in close collaboration with HFS and Illinois Public Health Institute. They did a lot of research with consumers to help us arrive at the proper and appropriate wording of all those questions.

In planning for GetCoveredIllinois, what has been the main target audience or audiences and are there any unique obstacles to reaching them that have driven outreach, communication, and policy strategies?

We are targeting the uninsured, so minorities are disproportionately represented in our target population. We were very sensitive to that, for example, when we awarded all of our in-person counselor grants through the Illinois Department of Public Health. We made sure, to the extent minorities are disproportionately represented in the uninsured target audience, that we had enough community-based organizations to reach them, and that they were going to be hiring enough Navigators to be able to reach those demographics.

GetCoveredIllinois is now fully translated in Spanish, and we also have Arabic, Chinese, Polish, Spanish, Tagalog, and Russian fact sheets. Then we have an inventory of what Navigators speak languages in addition to those, so if they call our call center they can be referred to a Navigator that speaks Urdu or another language.

Do you have a sense of what has been the most frequently asked question the Navigators have faced at the community events and through the hotline? Is it what you would have expected given the population targeted by GetCoveredIllinois?

We’ve been getting a higher proportion of folks asking about Medicaid than we expected. A lot of people have questions and concerns about the program and are not exactly sure what the expansion means even though we’ve been promoting the fact that Illinois did expand Medicaid. We are also getting questions about immigration status and what that means for the uninsured. Some of those questions are very complicated based on people’s personal circumstances, so we may refer them to a Navigator.

What is something about GetCoveredIllinois you believe people should be more aware of?

We have a screening tool available on the website, which includes six simple questions that are easy to answer and which will let you know with a high degree of accuracy whether you are marketplace- or Medicaid-eligible. If you are Medicaid-eligible, you can apply right now, because our Medicaid system is a state-run system and currently working. If you are marketplace-eligible, we are recommending that folks make an appointment with a Navigator. The full enrollment period lasts until the end of March, but we recommend that people not wait until then.

After this first open-enrollment ends in March 2014, what do you think will be the next priorities for GetCoveredIllinois?

Our first step is making people aware that they have new options available to them, our second step is to actually get people to enroll, and then I would say our third step is to make sure they understand how to stay insured, and how to use it appropriately. Again, our target audience is people who are uninsured, many of whom who have historically been uninsured for years or have never had insurance. We want to make sure people understand how to use the insurance.

Feature Photo: cc/(California Insurance Finder)