Overview
With the costs of health care skyrocketing, and 1.4 million Illinoisans currently going without health insurance, major reform is needed to improve public health and protect consumers.
Insurance companies need to change the way they do business.
Health insurance costs are soaring, and millions are going without any insurance or enough insurance to cover their families. Even worse, many people are refused coverage even if they can afford it.
At the same time, Illinois’ largest health insurance companies increased their profits an average of $675 million in the second quarter of 2007.
The problem is that insurance companies operate virtually unchecked in Illinois, and are making record-breaking profit. Health insurance companies can deny claims as they see fit, and no independent external review process exists for consumers. They are also free to use our money for profit and administrative costs instead of our health care. Finally, insurance companies are not subject to any government oversight before they raise our premiums.
Illinois PIRG is working to:
• Make insurance companies spend our money on our care.
Health insurance companies in Illinois take as much as 40% of our fees for their profit instead of our care. We are working to make companies spend at least 85% of our fees on our care.
• Keep insurance companies from unfairly denying or canceling coverage.
When insurance companies deny claims, increase renewal fees, or cancel coverage all together, the Office of Patient Protection will step in on behalf of consumers.
• Stop unfair rate increases.
When insurance companies unfairly raise rates, consumers cannot afford even the most basic coverage. To make sure rate increases are legitimate, Illinois should join other states that require insurance companies to get approval from the state watchdog before they raise rates.
We need to dramatically reduce or eliminate the number of uninsured.
Uninsured residents have or are at risk of significant financial hardship when they encounter health problems. The uninsured also drive up the cost of health care for everyone, because the uninsured have less access to preventative health care and they are more likely to go to the emergency room—the most expensive place to get treated—when they do have health problems.
While hospitals are required to treat everyone who needs medical attention, many uninsured do not have the money to cover this costly treatment. This is a big problem for some hospitals and doctors who treat the uninsured, but are never reimbursed for their services.
Health reforms under consideration would provide health insurance to most or all of the uninsured.
