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"Today, there are more than 250,000 kids in Illinois who
don't have health insurance," Blagojevich said. "That's 250,000 kids
who are less likely to go to the doctor for regular checkups, have
their cavities filled and get care for far more serious conditions.
These children living without health insurance are everywhere in our
state, in the smallest of towns and in the largest of cities. And
who are these kids? Let me tell you who they are not. They're not
children of politicians or the wealthy or even the poor. In their
own ways, those children typically have health insurance. Instead,
more often then not, the quarter-million kids in Illinois without
health coverage are the children of working families, the ones whose
parents form the backbone of this country. For these children,
middle class means caught in the middle. It's time for us to help.
It's time for us to reach out to those who are paying most of the
taxes and doing most of the work and make government work for them.
It's time to help them make sure that their kids have the same
chance at being healthy as every other kid."
Senate President Emil Jones and House Speaker Michael J. Madigan
are the lead sponsors of House Bill 806,
creating the All Kids health insurance program. The leaders have
vowed to push for its passage during the fall veto session that
began Tuesday. If the bill passes, the program can be up and running
by July 1, 2006.
Based on adjusted census data from 2003, 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.
To date, more than 400 organizations representing hospitals,
doctors, nurses, educators, labor, child advocates and clergy have
endorsed the All Kids program. Since he announced the plan earlier
this month, the governor has traveled the state and met countless
families that would benefit from All Kids, such as:
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Bianca Sanchez, from Chicago's
Southwest Side. As a single parent, Sanchez 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 means that she is 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.
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The Evans family from Chicago.
Michael and Tracie Evans have been married for more than 18
years, and for the last 15 years he has worked as a community
organizer with a not-for-profit while she home-schools the
children. Their four children -- Michelle, 15, Alisha, 14,
Janell, 13, and son Aaron, 11 -- lack the health insurance they
need because the cost of private insurance is out of reach, yet
their income is too high to be eligible for state health
insurance. Aaron has asthma, and they currently pay
out-of-pocket for the children's doctor visits at a nearby
clinic.
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The Ascensio family of southwest
suburban Romeoville. Brian Ascensio 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.
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The Meyer family from Caseyville.
Anthony Meyer works long hours for a small business in the Metro
East area, and his wife, Laura, cares for their three children
while maintaining a part-time job at a local church. Their
income is too high for their children to qualify for insurance
through the state, and the cost of private health insurance for
a family of five has been too expensive to afford.
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Sharlene Cook from the Quad
Cities. Sharlene is a single mother who lives in Moline and is
self-employed, running her own pet grooming business for the
past 18 years. Her daughter, Alexis, 10, has attention deficit
hyperactivity disorder and a minor heart condition that needs
monitoring. Alexis is uninsured and currently taking three
medications costing Sharlene $230 per month. Alexis'
prescriptions have recently run out, and Sharlene hasn't been
able to take her to the doctor because of the cost of going
without health insurance.
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The Archer Family from Mount
Vernon. Martin Archer works as a mechanic while wife Coby stays
at home to care for Dacota, 11, and Brittany, 8. 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.
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 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.
Despite these gains, there are still uninsured children in every
corner of the state. Twelve percent of children in Cook County, the
state's most populated county, 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 check-up 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.
[to top of second column in this article] |
 Participants in the new program will pay monthly premiums and
co-payments for doctor's 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, 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. 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 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 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. Families USA, a nonpartisan national health care policy
organization, released a new report this week finding that the
governor's All Kids program could generate $87 million in new
business activity and nearly $31 million in new wages statewide in
its first year of implementation. According to the study, the
program will capture approximately $37 million from the federal
government in matching funds for covering more children eligible for
Medicaid and the State Children's Health Insurance Program and for
speeding up the payment cycle for all doctors who treat children in
the state's children's health insurance programs. The $37 million in
federal funds from the program will have a direct effect on the
state's economy, as it's used to pay doctors, hospitals, clinics and
other health-related businesses. Providers then use the payments
they receive to buy goods and pay salaries, which, in turn, adds
more money to the economy that can be spent on other goods and
services. Using a U.S. Department of Commerce input-output model,
Families USA found that this ripple effect, also called the
"multiplier effect," is estimated to generate $87,561,000 in new
business activity and $30,769,000 in wages in the first year of the
program.
As the Families USA report demonstrates, investing in health
coverage provides benefits beyond the individual lives that are
helped. Health care is the second-fastest growing industry in the
state and one of the fastest in the nation. Over the past five
years, the health care industry has created nearly 40,000 new jobs
in Illinois.
Another way the plan can have a positive effect on the state's
economy is by helping to bring down the cost of private insurance.
When uninsured individuals seek medical care, it's often not until
they have become very ill or been seriously injured and need
expensive emergency care. 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. In a report released in June of 2005,
Families USA researchers found that premiums for families in
Illinois who have insurance through a private employer are $1,059
higher due to the cost of health care for the uninsured.
"To me, this issue is very simple," the governor said. "It comes
from a lesson we learned in Sunday school -- the golden rule. Do
unto others as you would have others do unto you. If we as
politicians and government officials are good enough to have health
insurance for our kids, then every parent is good enough to have
health insurance for their kids and every child has the right to get
the care they need."
[News release from
the governor's office] |
