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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 eye glasses and asthma inhalers.
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 $59,999 a year will pay a $40 monthly premium per child, and a
$10 co-pay per physician visit. A family with two children earning
between $60,000 and $79,999 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 check ups 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, expected to be $45 million in the first year, with
savings generated by implementing a primary care case management
model (PCCM) for participants in the state’s FamilyCare and All Kids
health care programs. 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 build up. 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.
Of the 253,000 children in Illinois without health insurance, more
than 11,000 live in the Southern Illinois and another 19,000 live in
the Metro East. Over half of Illinois’ uninsured children come from
working and middle class families who earn too much to qualify for
programs like KidCare, but not enough to afford private health
insurance. The Governor’s program would make comprehensive health
insurance available to children, with parents paying monthly
premiums and co-payments for doctor’s visits and prescription drugs
at affordable rates.
“I know from my own experience as a father how much parents care
about making sure their kids are safe and healthy. I can’t imagine
how hard it would be to watch one of my daughters cope with sickness
and not be able to take her to the doctor, or go the pharmacy to
pick up medicine. And yet there are more than a quarter of a million
children in Illinois whose parents are in that very situation
because they don’t have health insurance for their children. No
child should have to wait for medical attention until their only
option is the emergency room. Each and every child in Illinois
should have health care, and All Kids will make that possible,” said
Gov. Blagojevich.
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.
Over the past two and a half 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 as
the second best state in the nation by the Kaiser Family Foundation
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).
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Despite these gains, there are still uninsured children in every
corner of the state. Based on adjusted 2003 Census data,
approximately 253,000 children in Illinois do not have health
insurance, and 11,084 of them are from the Southern Illinois
counties including Alexander (406), Edwards (164), Franklin (1,047),
Gallatin (172), Hamilton (227), Hardin (83), Jackson (1,783),
Jefferson (1,108), Johnson (259), Massac (391), Perry (477), Pope
(99), Pulaski (309),
Randolph (661), Saline (736), Union (397), Wabash (277), Washington
(304), Wayne (369), White (302), and Williamson (1,513). Another
18,696 of them are from counties in the Metro East area, including
Jersey (478), Monroe (5,349), Madison (5,921), and St. Clair
(6,948).
The Archers, who hosted the Governor today, are a good example of
the kind of family that will benefit from All Kids. Martin Archer
works as a mechanic while wife Coby stays at home to care for Dacota
(11 years old) and Brittany (8 years old). Their income is too high
for the kids to qualify for insurance through the state, and the
cost of private health insurance for the children is out of reach.
As a result, Dacota and Brittany live without 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%
less likely than children with insurance to receive medical care for
conditions like ear infections, and 30% less likely to receive
medical attention when they are injured.
• A National Health Interview Survey found that 59% of uninsured
children did not see a doctor for a check-up in the past year and
38% 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.
It’s an accepted fact that every child has a right to attend school.
Why shouldn’t it be the same for health care?” the Governor said.
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 more than $56 million in the first year by
implementing the PCCM model in all state health programs but those
that serve seniors and the blind.
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 a Florida Healthy Kids Annual Report in 1997,
children who do not have health coverage are 25% 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%
• 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% of their medical bills out of pocket, more than
40% 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 $1059 to the
average family’s insurance premiums here in Illinois in 2005.
In addition, investing in health care can have a positive impact 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.
“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 hard working families like
the Archers,” the Governor concluded.
More information about All Kids is available online at
www.allkidscovered.com.
[News release] |
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