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"At one point or another, nearly
everyone has lived through the experience of seeing a loved one cope
with sickness or a serious injury," Blagojevich said. "You only have
to go through that experience once to know just how much it means to
have health insurance. Yet hundreds of thousands of children in
Illinois don't have health insurance. That means they can't see a
doctor when they need to, can't get the medicine they need, can't
get the care they need. And when they do get medical care, it's
often in the emergency room, after a small problem has grown into a
big problem. Children should have health care, and our new program
makes affordable, good health care available to every child in
Illinois." State Senate President Emil Jones and House Speaker
Michael J. Madigan have signed on as the lead sponsors of
legislation creating the "All Kids" health insurance program and
have vowed to push for its passage during the upcoming fall veto
session so the program can be up and running by July 1, 2006.
"The governor continues to make access to health care the
hallmark of his administration," Madigan said. "Today he is taking a
step to crush the final financial barrier and ensure every one of
our state's children receive all the important care they need."
"Health care costs for the average working family outpaced
inflation in the past year," Jones said. "Middle-income families are
being pushed to the limit, as are some employers, who are
considering cutting benefits or placing more health care coverage
costs on their workers. The All Kids plan provides a basic need for
Illinois families: preventative health care, so that an infection
doesn't turn into a trip to the emergency room or a mild case of
asthma isn't a life-threatening situation. All Kids will not only
provide much-needed affordable coverage, but will keep health care
costs down by providing preventative care."
Based on adjusted data from the 2003 census, approximately
253,000 children in Illinois do not have health insurance. That's
enough children to fill every one of the 43,000 hospital beds in
Illinois six times over. The governor's All Kids program would offer
children access to comprehensive health care, including doctor's
visits, hospital stays, prescription drugs, vision care, dental care
and medical devices like eyeglasses and asthma inhalers.
Over the past 2½ years, the Blagojevich administration has worked
to expand health coverage for low-income working parents and their
children. Since January of 2003, 170,000
more children in Illinois received health insurance, and
Illinois is now ranked by the Kaiser Family Foundation as the
second-best state in the nation for providing health care to
children who need it. Illinois is also now the top-ranked state in
the nation for providing health care to adults who need it.
Despite these gains, there are still uninsured children in every
corner of the state. In Cook County, the state's most populated
county, 12 percent of children are uninsured. In Pulaski County, at
the southern tip of Illinois, nearly 15 percent of children lack
health coverage. In St. Clair County, 9.3 percent of children do not
have health insurance. In Sangamon County, home to Illinois'
capitol, 8.6 percent of kids are not insured. Even in suburban
DuPage County, one of the 25 wealthiest counties in the United
States, 7.2 percent of children have no health insurance.
Research shows that uninsured children suffer because they do not
have access to adequate medical care. For example:
- The Kaiser Family Foundation found that uninsured children
are 70 percent less likely than children with insurance to
receive medical care for conditions like ear infections and 30
percent less likely to receive medical attention when they are
injured.
- A National Health Interview Survey found that 59 percent of
uninsured children did not see a doctor for a checkup in the
past year and 38 percent of children have no regular place to go
for medical care. These factors put uninsured children at higher
risk for hospitalization or missed diagnoses of serious
conditions.
"Our plan is based on a very simple principle: Everyone needs
health care and every child should have a way to get the care they
need," the governor said. "It's an accepted fact that every child
has a right to attend school. Why shouldn't it be the same for
health care?"
Participants in the new program will pay monthly premiums and
co-payments for doctors' visits and prescriptions, but unlike
private insurance that is too expensive for so many families, the
rates for All Kids coverage will be based on a family's income. The
state is able to offer All Kids insurance coverage at much lower
than market rates for middle-income families by leveraging the
significant negotiating and buying power it already has through
Medicaid.
For example, a family with two children that earns between
$40,000 and $59,000 a year will pay a $40 monthly premium per child
and a $10 co-pay per physician visit. A family with two children
that earns between $60,000 and $79,000 will pay a $70 monthly
premium per child and a $15 co-pay per physician visit. However,
there will be no co-pays for preventative care visits, such as
annual immunizations and regular checkups and screenings for vision,
hearing, appropriate development or preventative dental. These
premiums for middle-income families are significantly more
affordable than typical private insurance premiums of $100 to $200 a
month, or $2,400 per child annually.
The state will cover the difference between what parents
contribute in monthly premiums and the actual cost of providing
health care for each child, which is expected to be $45 million in
the first year, with savings generated by implementing a primary
care case management model for participants in the state's
FamilyCare and All Kids health care programs.
[to top of second column in this article]
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 Participants will choose a single primary physician who will
manage their care by ensuring they get immunizations and other
preventative health care services and avoid unnecessary emergency
room visits and hospitalizations. Patients with chronic conditions
like asthma or diabetes will have a single care manager to make sure
they are getting the treatments and ongoing care they need to avoid
acute care. Primary care physicians will make referrals to
specialists for additional care or tests as needed.
By ensuring patients get adequate preventative care on the front
end, fewer people will need expensive specialized care or emergency
care for critical conditions. In children, preventative care is
especially important. For example, infants with stomach flu
(gastroenteritis) who receive appropriate primary care can avoid
being hospitalized for dehydration. Providing a timely exam and
appropriate antibiotic treatment for children with ear infections (otitis
media) can prevent chronic ear problems, loss of hearing and the
need for surgically placed tubes to relieve fluid buildup. Treating
children with bronchitis or minor lung infections in a primary care
setting can help to avoid more expensive hospitalization treatment
of pneumonia, including intravenous antibiotics and respiratory
treatments. And early identification and appropriate treatment of
children who have chronic illnesses, such as asthma, will result in
fewer expensive emergency room and inpatient care visits.
Twenty-nine other states -- including North Carolina, New York,
Texas, Pennsylvania and Louisiana -- have realized significant
savings by using this model for their Medicaid programs. Based on
independent analyses, the Department of Healthcare and Family
Services estimates the state will save $56 million in the first year
by implementing the primary care case management model in all state
health programs except those that serve seniors and the blind.
Several parents whose children live without health care joined
the governor Thursday to discuss the All Kids program. The Ascensio
family of southwest suburban Romeoville is the picture of the
"all-American family." High school sweethearts who eventually
married, Brian works at an engineering firm while wife Tiffany stays
home to care for their three children. Their annual income of
$63,000 is too high for them to qualify for state insurance, but
they cannot secure private coverage for their 7-year-old daughter
Savannah because she has interstitial cystitis, a painful condition
that requires $200 for a three-month supply of medication.
Consequently, Savannah lives without health insurance, and the
family has had to remove their children from after-school activities
in order to pay for Savannah's care.
Similarly, single parent Bianca Sanchez, from Chicago's Southwest
Side, described how she has struggled to care for Soledad, her
7-year-old asthmatic daughter. An aide in a doctor's office,
Bianca's annual salary of approximately $36,000 meant that she was
caught in the middle -- ineligible for state health insurance but
unable to purchase private coverage. As a result, she is just
scraping by in her effort to meet Soledad's medical needs.
Evidence shows that in addition to lacking adequate medical care,
children without health insurance are at a disadvantage in the
classroom. For example:
- According to the Florida Healthy Kids Annual Report in 1997,
children who do not have health coverage are 25 percent more
likely to miss school.
- A California Health Status Assessment Project on children's
health, published in 2002, found that children who recently
enrolled in health care saw their attendance and performance
improve by 68 percent.
- And a 2002 study in Vermont, entitled "Building Bridges to
Healthy Kids and Better Students," conducted by the Council of
Chief State School Officers, showed that children who started
out without health insurance saw their reading scores more than
double after getting health care.
Research also provides strong economic reasons for insuring all
children. Delayed treatment can result in more complex, more
threatening and more expensive care later. While the uninsured pay
approximately 35 percent of their medical bills out-of-pocket, more
than 40 percent ends up being absorbed by those who do have health
insurance, in the form of higher premiums. According to a recent
Families USA report, the cost of paying for the uninsured will add
$1,059 to the average family's insurance premiums here in Illinois
in 2005.
In addition, investing in health care can have a positive effect
on local economies. Over the past five years, the health care
industry has created nearly 40,000 new jobs in Illinois. Health care
is the second-fastest growing industry in the state and one of the
fastest in the nation.
The governor concluded: "We know providing every child with
health coverage will mean better attendance and performance in our
schools. We know it will reduce the pressure on insurance premiums.
We also know it can boost our local economies and improve
productivity in the workplace. But more than any of these things,
giving every child the chance to grow up healthy is the right thing
to do. And I'm proud that we have a chance to make that goal a
reality for hardworking families like the Ascensios, the Sanchezes
and thousands of others."
More information about All Kids is available online at
www.allkidscovered.com.
[News release from the governor's
office] |
