Article, NY Times: Illinois Law Offers Coverage for Uninsured Children

November 16, 2005
Illinois Law Offers Coverage for Uninsured Children
By MONICA DAVEY

CHICAGO, Nov. 15 - Gov. Rod R. Blagojevich signed a measure on Tuesday intended to allow all children in Illinois, including those in working-class and middle-class families, to obtain health insurance.
National experts on health care said the new law, which will offer discounts on premiums for those who qualify, was the broadest plan to insure children by any state.
Political leaders in other states, the experts said, are certain to be watching whether Illinois succeeds in expanding coverage to its 250,000 children who are now uninsured, about half of whom are not from the poorest families but from families earning more than $40,000 a year.
Mr. Blagojevich, a Democrat, said he hoped that the move would lead the way for a nation that needs to face a growing problem of middle-income families who cannot afford insurance premiums.
"It's about time that the middle class get some help and the working class get some help," he said in an interview. "Our kids come first, and what's the most important thing for kids? That they're safe and healthy."
Within hours of the signing on the Southwest Side of Chicago, residents submitted contact information to enroll online, though the benefits do not begin until July. By the end of the day, hundreds of people had written in, Mr. Blagojevich's office said.
Although few people here wanted to be viewed as opposing children's having insurance, a concept that one skeptical legislator compared to siding against motherhood or apple pie, Mr. Blagojevich has his doubters.
Critics of the program, which the governor says will cost $45 million in its first year, said they feared that such a sweeping offer could end up costing far more at a time when the state's budget is strained and that it might turn Illinois into a refuge for families from other states desperate to insure their children.
The critics also complained that the push for this bill, which sped through the Democratic-controlled Legislature, was a publicity stunt by Mr. Blagojevich, a first-term governor who might seek re-election next year and whose administration has received unflattering headlines over a federal inquiry into its hiring practices.
"This is the playbook of a guy who literally wants to turn the page and talk about something else," said State Senator Peter J. Roskam, a Republican from Wheaton who opposed the plan, saying it left numerous unanswered questions about eligibility and costs. "I think it's a landmark that's going to turn into a shipwreck."
Mr. Roskam added that the number of words in the governor's press releases on the program had by far eclipsed the number of words in the actual bill. The press release on Tuesday announcing the signing ran nine pages.
Aides to Mr. Blagojevich said the program, known as All Kids, was meticulously detailed and would work. Families who earn too much to be eligible for the existing state and federally financed health programs, including the widely available KidCare, may buy in to the new plan.
The state costs, the aides said, will be paid for by shifting the management of 1.7 million Medicaid recipients. Those patients will no longer go to any doctor on a list of eligible doctors, but to a single physician who will work on more problems earlier, saving an estimated $56 million the first year.
A family's costs for All Kids will depend on the household income. A family of four earning $41,000 a year will pay $40 a month for one child or $80 a month for two or more children. The co-payment for doctors' visits will be $10 each. A family of four earning $61,000 to $79,000 will pay $70 for one child and $140 for two or more children. The co-payment will be $15.
People with higher incomes and without insurance are also eligible, though the premiums increase significantly. To prevent people from dropping their insurance to switch to the state insurance, children will initially be required to be uninsured since Jan. 1, 2006, or in later years one full year without insurance.
Other states have tackled the same issue, but none have settled on a program as sweeping or comprehensive as the Illinois law, according to Diane Rowland, executive vice president of the Kaiser Family Foundation, a health research group.
In California last month, Gov. Arnold Schwarzenegger, a Republican, vetoed a bill that would have provided access to coverage for all uninsured children in that state, saying that he believed children should be insured but that the bill failed to detail how to pay for the plan.
Massachusetts has a plan similar to Illinois's but less extensive, a comparison shows. Although Massachusetts offers coverage to all children, the coverage is limited for benefits like prescription medicines, eyeglasses, hearing aids, and mental health and substance abuse services.
Under the Illinois plan, a spokeswoman for the governor said, those benefits will have no limits.
"Other states are going to watch this very closely," said Alan R. Weil, executive director of the National Academy for State Health Policy, a nonpartisan research organization. "There is broad interest in covering kids, and there will be interest in following Illinois if the story there turns out to be good."
As officials elsewhere wait to see how the plan works and whether the state can afford it, some residents here say they have all the answers they need.
In Carol Stream, a suburb west of Chicago, Annette C. Akey said she was deeply relieved at the prospect of the new coverage. As owners of a real estate company who make about $60,000 a year, Ms. Akey and her husband reluctantly gave up family health insurance coverage as the premiums soared to more than $500 a month a few years ago, she said.
"It was a matter of paying the high premiums or keeping the business," Ms. Akey said.
Not long ago, though, their daughter, Katana, 6, became sick. Doctors concluded that she had a kidney problem and a heart murmur, Ms. Akey said, and a three-and-a-half day hospital stay left the Akeys $10,000 in debt and seeking a second mortgage on their house.
Governor Blagojevich, who has not announced whether he will run for re-election, dismissed critics of his plan. Although attention around the governor has in recent weeks focused on federal subpoenas for hiring records, he has said his administration has done nothing wrong.
He said he had been working on the children's insurance program for years.
"If they want to accuse me of doing it because I want to run for re-election, they're free to do it," he said in the interview. "I'm going to let my actions speak for themselves."
Gretchen Ruethling contributed reporting for this story.

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ORC 3307.15 - not just a wish, IT'S THE LAW!