THE BLOG
10/28/2013 04:46 pm ET Updated Jan 23, 2014

Blue Cross Blue Shield "Bronze Plan" Faces Springfield Fight

The Blues' and their "Bronze Plan" are in for a fight.

While media coverage of the Illinois legislature's fall veto session has been dominated by pension reform, same sex marriage, and mandatory minimum on guns, a big fight has broken out between the state's top insurance company on one side and other insurance giants, consumer groups, and a key labor union on the other.

On October 16, the House Rules Committee moved to third reading legislation, Senate Bill 1547, that allows Blue Cross Blue Shield of Illinois to create a Exclusive Benefits Options plan, a plan that would exclude out-of-network coverage.

The bill has raised Cain and cackles among a range of groups.

Leading the charge against the legislation, sponsored by House Deputy Majority Leader Lou Lang (D-Skokie), are Aetna, Humana, and the Illinois Life Insurance Council.

Joining the big insurance firms in opposition are AIDS Foundation of Chicago, Illinois Planned Parenthood, Aids Legal Council of Chicago, Metropolitan Chicago Breast Cancer Task Force, Heartland Alliance for Human Needs & Human Rights, Sargent Shriver National Center on Poverty Law, and Illinois Department of Insurance.

And SEIU just added itself to the opposition.

After the measure was amended with the controversial provision, House Amendment #1, on May 29, 14 co-sponsors bailed: State Reps. Tom Demmer, Laura Fine, Fran Hurley, Toni Berrios, Robyn Gabel, Naomi Jakobsson, Larry Walsh, Jr., Will Davis, Pam Roth, and Senators Iris Martinez, John Mulroe, Michael Hastings, Sam McCann, Bill Brady, and Tim Bivins. Lang shelved the bill and encouraged the parties to negotiate their differences over the summer.

In the meantime, another sponsor is beginning to wobble.

Currently, the Department of Insurance has denied the request for EPO benefit plans based on existing Illinois law that aims to prevent insurance companies from bolstering particular hospitals or physicians.

Lang, who says he has the votes to pass the bill and that he intends to call it when the legislature returns to Springfield on November 5, counters that the Affordable Care Act requires an affordable, Bronze-like plan, and that Blue Cross Blue Shield's EPO meets that requirement.

"The Affordable Care Act requires an affordable option, a bronze plan, that gives people a cost-conscious option that fits their budget," Lang said. "If there are only expensive plans, there will not be any other plan. Many large companies already have these types of plans; so, this is nothing new."

Lang noted that 200,000 Illinois workers already have such, basic plans through their employers, such as United Airlines, Men's Warehouse, and Winston & Strawn.

Another bill sponsor, State Rep. Mike Zalewski (D-Riverside) echoed Lang's position.

"I think it's a good thing when the marketplace can offer consumer choice," Zalewksi stated. "It might not be the preferred choice for every Illinoisan, but there may be instances when it can provide cost savings to a consumer, and I think that's a proposal worthy of support."

Sources says that Blues lobbyists are scrambling to keep their "yes" votes in line.

Meanwhile, while opponents acknowledge that Illinois needs EPO options, they want to keep the Blue Cross at the negotiating table because they argue that most insurers will refuse to offer such a limited options, but are also working their roll call to hold their "no" votes and pick off more of Lang's "yes" votes.

Stay tuned.

DavidOrmsby@DavidOrmsby.com

David also edits, with the help of Capitol Fax's Rich Miller,
The Illinois Observer: The Insider, in which this article first appeared.