Powerful Illinois House Speaker Michael Madigan won’t accept a Senate bill to establish a health coverage exchange after a House version passed last month, sources say. At the root of the problem is the fact that the House bill is being slammed by health care advocates because it lacks consumer protection. Meanwhile, the Senate version is gaining traction with over a dozen co-sponsors signing on already. Progress Illinois has covered both the competing plans, and today, we caught up with the Campaign for Better Health Care’s executive director, Jim Duffett, to hear about the latest developments.

The House Bill (HB 1577), Duffett says, was rushed through committee for a hurried vote, leaving advocates with no time to warn House representatives of the pending Senate version. Although insurance companies were initially on board with the Senate bill, they changed course and orchestrated the House version. Calling it a “backdoor political game,” Duffett said this was made possible because the bill’s sponsor, Frank Mautino (D-Spring Valley,) also happens to be chairman of the Insurance Committee. It’s no wonder, then, that the House bill lacks both the comprehensive governance and consumer protections of which the Senate bill boasts.

Sponsored by State Sen. David Koehler (D-Peoria), who used the Massachusetts exchange as a model, SB 1729 calls for some independence from its governing body, which Duffett calls a “quasi-government” model. SB 1729 would establish an exchange that will be governed by a nine-member board made of up health care consumers, providers, small business, employees, labor, and insurance producers. The members will be appointed by the governor and attorney general and confirmed by the Senate. The bill was created with input from the Illinois Health Care Reform Implementation Council (which the Campaign for Better Health Care has representation in) and its strong conflict-of-interest rules have been praised by The Sargent Shriver National Center on Poverty Law.

Duffett said that while there is a lot of support in both assemblies for Koehler’s bill, Madigan has made it clear that it would be “unacceptable” to pass it. So now, the state Senate is holding on to both bills in hopes of a compromise. Otherwise, Duffett said a watered-down “low level” bill could be passed instead, so that the exchange can start forming before the specifics are hashed out. “Now it boils down to some level of negotiations,” Duffett said. “There can be a compromise.”