SPRINGFIELD – The Illinois Senate Executive Committee today approved Governor Rod R. Blagojevich’s landmark proposal that would make Illinois the only state in the nation to provide affordable, comprehensive health insurance for every child in the state. Sponsored by State Senate President Emil Jones and House Speaker Michael J. Madigan, House Bill 806 creating All Kids now moves to the full senate for consideration.
“I applaud the committee for taking the first step toward making sure every child in Illinois has access to comprehensive and affordable health care,” said Governor Blagojevich. “My daughters are fortunate enough to have healthcare coverage and they can see a doctor when they are sick or injured. But, there are hundreds of thousands of children in this state who don’t have the ability to see a doctor or get the medicines they need when they are ill. We can change this if we pass our All Kids plan.”
Committee members listened to testimony from several parents whose children live without health care and would benefit from the All Kids program. Bianca Sanchez, from Chicago, described how she struggles to care for Soledad, her 7-year old asthmatic daughter. As an aide in a doctor’s office, Bianca’s annual salary is too much to qualify for KidCare but not enough to afford private insurance for Soledad. Bianca, like so many other families in Illinois, is caught in the middle and as a result, she is just scraping by in her effort to meet Soledad’s medical needs.
Tracie Evans also told committee members how she and her husband Michael have been married for over 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.
Based on adjusted 2003 Census data, approximately 253,000 children in Illinois do not have 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. The 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.
“The Governor’s All Kids program will improve the lives of hundreds of thousands of working families across the state of Illinois,” said Barry Maram, director of the Illinois Department of Healthcare and Family Services. “The majority of children who lack health insurance belong to working families who earn too much for public assistance, yet too little for private insurance. These are families that play by the rules, pay their taxes and earn a living, but still don’t have access to affordable health care for their children. Every child should be able to see a doctor when they are sick, not just the privileged few.”
On Monday, Families USA, a non-partisan national health care policy organization, released a new report finding that Governor Rod R. Blagojevich’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. Ron Pollack, Executive Director of Families USA also attended today’s Senate Executive Committee hearing.
“The All Kids program will be a win-win proposition for Illinois. It will improve the health and educational opportunities for the state’s children and it will also stimulate and improve the state’s economy,” Ron Pollack said. “The All Kids program is also likely to become a model for other states and for the federal government when it re-authorizes the State Children's Health Insurance Program in 2007. As a result, the Governor is to be commended for his proposal and it makes sense for the state legislature to enact it and as soon as possible.”
According to the new Families USA 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 new federal funds from All Kids will have a direct impact on the state’s economy, since the funds are 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.
Health care is the second-fastest growing industry in Illinois, and among the fastest in the nation. Over the past five years, the health care industry has created nearly 40,000 new jobs in Illinois.
During the last 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 indicates that by providing comprehensive health insurance for children in Illinois, we will have an opportunity to improve the overall future of the state,” said Dr. Anne Marie Murphy. “Healthy children attend more school, which would help their education and increase test scores. Economically, providing preventative care and monitoring early symptoms of ailments will decrease the amount of the currently uninsured emergency room visits that drive up the cost of coverage for the privately insured. Investing in health care for people who need coverage will also help generate millions of dollars in new business activity and new wages into the state.”
If the legislation passes during the fall veto session, which began today, the All Kids program can be up and running by July 1, 2006. More information about All Kids is available online at www.allkidscovered.com.