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"Passing the All Kids plan
is a landmark achievement in Illinois," Blagojevich said. "Every
child deserves the chance to be healthy. We've worked hard for three
years to make health care available for more working and low-income
families. But thousands of kids from working-class and middle-class
families have fallen through the cracks because their families earn
too much to qualify for government programs but still can't afford
private insurance. That's not what the American dream is all about.
This week, we took the opportunity to make sure that every child in
Illinois has access to affordable, good health insurance. This is
the right thing to do now, and it's the right thing to do for our
future. And, I applaud every single legislator who helped make this
a reality,"
"Once again, let me commend the governor for taking the steps to
smashing the economic barriers to good health insurance for all of
our children," said Madigan, the House speaker. "I am pleased to be
a sponsor of this effort."
"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 will 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.
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.
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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.
More information about the program is available online at
www.allkidscovered.com.
[News release from the governor's
office] |
