Gov. Blagojevich's All Kids plan passes in Senate, heads to House for final passage         

[OCT. 27, 2005]  SPRINGFIELD -- The Illinois Senate today (Thursday) approved Gov. Rod R. Blagojevich's landmark proposal that would make Illinois the only state in the nation to provide affordable, comprehensive health insurance for every child in the state. After a 32-23 vote in the Senate, the legislation now moves to the Illinois House of Representatives for final passage. House Bill 806, creating All Kids, is sponsored by state Senate President Emil Jones and House Speaker Michael J. Madigan.

"The Illinois Senate took a significant step today toward making sure every child in Illinois has access to comprehensive and affordable health care," Blagojevich said. "There's nothing more important to parents than 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 I encourage members of the House to pass All Kids to make that possible."

"All Kids provides affordable health care insurance with a primary care physician and reduces the payment cycle for doctors," said Jones, the Senate president. "This program is a win-win for the family, the provider and the state."

In Illinois, 253,000 children are without health insurance. More than 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.

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 240 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.

Over the last 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 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.

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 health insurance programs for children. The $37 million in federal funds from the All Kids program will have a direct impact 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 All Kids 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 have 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.

If the legislation passes during the fall veto session, which began Tuesday, the All Kids program can be up and running by July 1, 2006. More information about the program is available online at www.allkidscovered.com.

[News release from the governor's office]

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