CHICAGO – Governor Rod R. Blagojevich today unveiled a landmark proposal that would make Illinois the first state in the nation to provide affordable, comprehensive health insurance for every child in the state. At a meeting with several middle-income families from the Chicago area who all make too much to qualify for state-funded healthcare, but cannot afford the high cost of private insurance, the Governor laid out his plan to ensure that every child in Illinois has access to affordable health insurance. Of the 253,000 children in Illinois without health insurance, more than half 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 doctors’ visits and prescription drugs at affordable rates.
“At one point or another, nearly everyone has lived through the experience of seeing a loved one cope with sickness or a serious injury. You only have to go through that experience once to know just how much it means to have health insurance. Yet hundreds of thousands of children in Illinois don’t have health insurance. That means they can’t see a doctor when they need to, can’t get the medicine they need, can’t get the care they need. And when they do get medical care, it’s often in the emergency room, after a small problem has grown into a big problem. Children should have health care and our new program makes affordable, good health care available to every child in Illinois,” 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.
“The Governor continues to make access to health care the hallmark of his administration. Today he is taking a step to crush the final financial barrier and ensure every one of our state's children receive all the important care they need,” said Speaker Madigan.
“Health care costs for the average working family out-paced inflation in the past year. Middle-income families are being pushed to the limit as are some employers, who are considering cutting benefits or placing more health care coverage costs on their workers. The All Kids plan provides a basic need for Illinois families: preventative healthcare, so that an infection doesn’t turn into a trip to the emergency room or a mild case of asthma isn’t a life-threatening situation. All Kids will not only provide much-needed affordable coverage, but will keep health care costs down by providing preventative care,” said President Jones.
Based on adjusted 2003 Census data, 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 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).
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% of children lack health coverage. In St. Clair County, 9.3% of children do not have health insurance. In Sangamon County, home to Illinois’ capitol, 8.6% of kids are not insured. Even in suburban DuPage County, one of the twenty-five wealthiest counties in the United States, 7.2% 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% 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.
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 $59,000 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 $79,000 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 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.
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 PCCM model in all state health programs but those that serve seniors and the blind.
Several parents whose children live without health care joined the Governor today to discuss the All Kids program. The Ascensio family of southwest suburban Romeoville is the picture of the “All-American” family. High school sweethearts who eventually married, Brian 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.
Similarly, single parent Bianca Sanchez, from Chicago’s Southwest Side, 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 meant that she was 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.
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 Ascensios, the Sanchezes and thousands of others,” the Governor concluded.
More information about All Kids is available online at www.allkidscovered.com.