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"Every child deserves the
opportunity to grow up healthy," Blagojevich said. "Starting in
July, Illinois parents who are working hard to make ends meet but
still can't afford private health insurance for their children will
finally have an affordable option in the All Kids program. There are
close to a quarter-of-a-million of those kids in Illinois, and
millions more across the country, that we cannot allow to fall
through the cracks in the health care system." Families USA is a
nonprofit, nonpartisan organization dedicated to securing
high-quality, affordable health care. The award the governor
received was named after Philippe Villers, the founder of Families
USA.
"The All Kids plan is an enormous breakthrough that may become a
model for other states and the federal government, encouraging them
to extend help to children all across the country," said Ron
Pollack, executive director of Families USA.
In December, U.S. Sen. Dick Durbin, D-Ill., and U.S. Rep. Rahm
Emanuel, D-Ill., introduced the federal All Kids Health Insurance
Coverage Act of 2005, modeled after Blagojevich's All Kids health
insurance legislation. Durbin and Emanuel's bill would help states
provide access to health insurance for all children by expanding the
State Children's Health Insurance Program. The act would eliminate
the federal eligibility cap of 200 percent of the federal poverty
level so that all children can be eligible for SCHIP, regardless of
family income.
Of the 250,000 children in Illinois without health insurance,
half come from working and middle-class families that 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, including
doctors' visits, hospital stays, prescription drugs, vision care,
dental care and medical devices like eyeglasses and asthma inhalers.
Parents will pay monthly premiums and co-payments for doctors'
visits and prescription drugs at affordable rates.
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
that earns 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 preventive care visits, such as
annual immunizations and regular checkups and screenings for vision,
hearing, appropriate development or preventive 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 preventive 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.
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 By ensuring patients get adequate preventive care on the front
end, fewer people will need expensive specialized care or emergency
care for critical conditions. In children, preventive 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.
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.
Research 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 added
$1,059 to the average family's insurance premiums 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. Families USA found that for every $1 million
invested in health care for people who need coverage, an additional
$2.4 million is generated in new business activity and $840,000 in
new wages.
While All Kids coverage does not begin until July 1,
preregistration is now under way in order to expedite the
application process so children can enjoy the benefits of the
program as soon as All Kids takes effect. The forms are now
available online at
www.allkidscovered.com in eight languages -- English, Chinese,
Hindi, Korean, Polish, Russian, Spanish and Vietnamese -- with more
translations on the way. The forms can also be requested by calling
1 (866) ALL-KIDS [1 (866) 255-5437] to receive them in the mail.
Once a preregistration form is received, the Illinois Department
of Healthcare and Family Services will process the information and
mail parents a letter to explain the next steps in the application
process. When it is time to apply, the department will mail each
family an All Kids application that will be partially filled out,
based on the information provided during preregistration. Children
who are determined to be eligible for KidCare can apply immediately
to receive health coverage. Families not currently eligible for
KidCare may apply early this year for the benefits that will begin
July 1.
More information about All Kids is available online at
www.allkidscovered.com.
[News release from the governor's
office]
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