SPRINGFIELD – To a rare joint session of the Illinois General Assembly on the first day of the 2005 fall veto session, Governor Rod R. Blagojevich today urged legislators to vote for his All Kids proposal, legislation that would make Illinois the only state in the nation to make affordable, comprehensive health insurance available to every child in the state.
“Today, there are more than 250,000 kids in Illinois who don’t have health insurance. That’s 250,000 kids who are less likely to go to the doctor for regular check ups, have their cavities filled, and get care for far more serious conditions. These children living without health insurance are everywhere in our state, in the smallest of towns and in the largest of cities. And who are these kids? Let me tell you who they are not. They’re not children of politicians, or the wealthy or even the poor. In their own ways, those children typically have health insurance. Instead, more often then not, the quarter-million kids in Illinois without health coverage are the children of working families, the ones whose parents form the backbone of this country. For these children, middle class means caught in the middle. It’s time for us to help. It’s time for us to reach out to those who are paying most of the taxes and doing most of the work and make government work for them. It’s time to help them make sure that their kids have the same chance at being healthy as every other kid,” said Gov. Blagojevich.
State Senate President Emil Jones and House Speaker Michael J. Madigan are the lead sponsors of House Bill 806, creating the All Kids health insurance program. The leaders have vowed to push for its passage during the fall veto session that begins today. If the bill passes, the program can be up and running by July 1, 2006.
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.
To date, more than 400 organizations representing hospitals, doctors, nurses, educators, labor, child advocates and clergy have endorsed All Kids. Since he announced the plan earlier this month, the Governor has traveled the state and met countless families that would benefit from All Kids including:
- Bianca Sanchez, from Chicago’s Southwest Side. As a single parent, Sanchez 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 means that she is 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.
- The Evans family from Chicago. Michael and Tracie Evans have been married for more than 18 years and for the last 15 years, he has worked as a community organizer with a not-for-profit while she home-schools the children. Their four children, Michelle (15 years old), Alisha (14 years old), Janell (13 years old) and son Aaron (11 years old) lack the health insurance they need because the cost of private insurance is out of reach, yet their income is too high to be eligible for state health insurance. Aaron has asthma and they currently pay out-of-pocket for the children’s doctor visits at a nearby clinic.
- The Ascensio family of southwest suburban Romeoville. Brian Ascensio 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.
- The Meyer family from Caseyville. Anthony Meyer works long hours for a small business in the Metro East area, and his wife Laura cares for their three children while maintaining a part-time job at a local church. Their income is too high for their children to qualify for insurance through the state, and the cost of private health insurance for a family of five has been too expensive to afford.
- Sharlene Cook from the Quad Cities. Sharlene is a single mother who lives in Moline and is self-employed, running her own pet grooming business for the past 18 years. Her daughter Alexis (10 years old) has Attention Deficit Hyperactivity Disorder (ADHD) and a minor heart condition that needs monitoring. Alexis is uninsured and currently taking three medications costing Sharlene $230 per month. Alexis’ prescriptions have recently run out and Sharlene hasn’t been able to take her to the doctor because of the cost of going without health insurance.
- The Archer Family from Mt. Vernon. Martin Archer works as a mechanic while wife Coby stays at home to care for Dacota (11 years old) and Brittany (8 years old). Their income is too high for the kids to qualify for insurance through the state, and the cost of private health insurance for the children is out of reach. As a result, Dacota and Brittany live without health insurance.
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.
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.
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. Families USA, a non-partisan 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, All Kids will capture approximately $37 million from the federal government in matching funds for covering more children eligible for Medicaid and SCHIP and for speeding up the payment cycle for all doctors who treat children in the state’s children’s health insurance programs. The $37 million in federal funds from All Kids 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 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 All Kids.
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 impact 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 been seriously injured and need expensive emergency care. 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. 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.
“To me, this issue is very simple. It comes from a lesson we learned in Sunday school – the golden rule. Do unto others as you would have others do unto you. If we as politicians and government officials are good enough to have health insurance for our kids, than every parent is good enough to have health insurance for their kids and every child has the right to get the care they need,” said the Governor.