Congressional Republicans, emboldened by the gains they made on Election Night last week, have the new federal health care law in their sights. At a Heritage Foundation speech last week, Senate Minority Leader Mitch McConnell (R-KY) said he was actively looking for ways to defund the implementation of the reform package, which won't go into effect fully until 2014. Illinois' own U.S. Rep. John Shimkus, who is angling to take over as chair of the House Energy and Commerce Committee, has promised to push hard for a full repeal if his party selects him for the powerful position.

This is folly. Although a plurality of survey respondents say they support a full or partial repeal of the legislation, huge majorities support virtually every major component it contains, from closing the Medicare "doughnut hole" to the subsides working people will eventually receive to pay for premiums. (The only provision that polled poorly was the so-called individual mandate, which cannot be taken out of the bill if its to work as designed.) "Eventually," notes the Washington Post's Ezra Klein, "the GOP is going to stop being on the side of health-care repeal and find themselves on the side of allowing insurers to discriminate against the sick."

Illinois health care officials are taking that promise to protect people with preexisting conditions seriously. Two months ago, using $196 million in grant money awarded by the U.S. Department of Health and Human Services (HHS), the state established the Illinois Pre-Existing Condition Insurance Plan (IPXP), a new high-risk health insurance pool.

IPXP -- which is open to anyone who has been uninsured for six months, has a pre-existing condition, and can't get insurance through an employer -- is a lifeline for individuals shut out of the private health insurance market because of chronic illnesses or disabilities. Although there is a $2,000 deductible, the pool's plan provides a reasonable out-of-pocket limit of $5,950 and modest monthly premiums (PDF) that cannot exceed prevailing market rates. (Indeed, Illinois' plan is more affordable (PDF) than those in most other states.) Most importantly, it acts as a bridge to 2014, when IPXP enrollees will be free to join the state's new health insurance exchange, which will offer subsidized coverage and prohibit discrimination based on medical history.

According to data collected by HHS, 664 individuals have signed up for IPXP in its first two months of operation. In the past nine days, Illinois Insurance Director Michael McRaith says 70 more people were added to the rolls. (Six others canceled their coverage.) While nationally, some are questioning the pace at which people are joining state pools, McRaith and his staff are "pleased with the initial expression of interest" here. Close to 2,000 Illinoisans have filled out applications online, up from 1,000 at the end of August. Because the process requires that potential enrollees submit paperwork that can't be transmitted through the Internet, it takes time to sort through the data.

In the coming months, McRaith's department is ramping up "targeted outreach" efforts to raise awareness about IPXP. Their focus is on provider and consumer advocacy groups who are in regular contact with potential applicants and state lawmakers, many of whom field calls about insurance woes constantly. There's enough federal funding currently to support between 4,000 and 6,000 patients, depending on who signs up. "We want to cover as many as we can, as quickly as we can," McRaith says. (The online application is available here.)

The pitch shouldn't be too hard; IPXP is a slightly better deal than the state's two existing high-risk pools, which cover roughly 16,000 individuals in the state. Historically, the annual premiums in those pools were high, averaging about $7,600 per person annually. The state is also looking at expanding coverage options under IPXP, by tinkering with both deductible levels and benefits, in an attempt to appeal to a broader range of potential enrollees. (Starting on January 1, there will be more options for folks enrolled in the 24 high-risk insurance pools under federal control.)

The number of people in Illinois who could benefit from IPXP is enormous; the Government Accountability Office estimates that of the roughly 1.7 million people who lack insurance, some 218,000 have at least one chronic condition that may prevent them from signing up on the individual market.

To bolster IPXP's reach significantly, however, more cash would be needed. The Affordable Care Act does stipulate that HHS can review the progress of individual states and reallocate money from those that aren't utilizing the resources properly to those that are. (That is, if Shimkus and his friends don't cut out the appropriation entirely.) While McRaith says he is not banking on getting more money from Washington next year, he's open to receiving a greater share.

"We're not where we want to end up," he says, "but we're certainly happy with our progress."