CHICAGO – The Illinois State Medical Society today endorsed Governor Rod R. Blagojevich’s landmark All Kids proposal that would make Illinois the only state in the nation to provide affordable, comprehensive health insurance for every child in the state. The Illinois State Medical Society (ISMS) represents more than 14,000 physicians from all specialties and practice types, as well as advocates for patients. ISMS joins more than 400 organizations representing medical facilities, doctors, nurses, educators, labor, child advocates and clergy that have endorsed the Governor’s plan since he introduced it two weeks ago.
“In broadening patient access to medical care, All Kids furthers one of the medical society’s foremost, long-standing aims,” Craig A. Backs, M.D., President of the Illinois State Medical Society, noted. “Getting more kids to see their doctors regularly – before major, costly medical problems erupt – that’s All Kids’ core premise. It’s sound medicine and sound public policy.”
“The children of our state need proper healthcare now so that they can mature into the productive and healthy citizens who will contribute to Illinois’ future,” said Gov. Blagojevich. “I am glad to have the Illinois State Medical Society join with myself and the more than 400 other groups who share in that aim.”
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.
Senate President Emil Jones and House Speaker Michael J. Madigan are the lead sponsors of House Bill 806, legislation creating the All Kids health insurance program. The leaders have vowed to push for its passage during the fall veto session that began today so the program can be up and running by July 1, 2006. The organizations vowed to help the Governor build support to pass his All Kids plan and to help enroll children in the plan, should it pass.
Based on adjusted 2003 Census data, approximately 253,000 children in Illinois do not have health insurance. 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.
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 eye glasses and asthma inhalers.
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.
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 $59,999 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 $79,999 will pay a $70 monthly premium per child, and a $15 co-pay per physician visit. However, there will be no co-pays for 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.
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 more than $56 million in the first year by implementing the PCCM model in all state health programs but those that serve seniors and the blind.