Illinois: Universal Coverage for Children

Illinois' All Kids health insurance program was enacted in November 2005, pre-registration began soon after, and coverage is expected to become effective in July 2006. Championed by Governor Blagojevich, All Kids provides a comprehensive health insurance coverage option to all uninsured children in Illinois. Monthly premiums and copayments vary based on family income, with rates for middle-income families much lower than in private market plans. A family of four with an annual income between $40,000 and $60,000, for example, will pay a $40 monthly premium per child and a $10 copayment per physician visit.

While more than 400,000 residents attained coverage over the past three years through expansions of existing state health programs, roughly 250,000 Illinois children remain uninsured. About half of them qualify for some form of public insurance but aren't enrolled. Christine Glunz, spokeswoman for the Illinois Department of Healthcare and Family Services, notes that most uninsured children come from working families earning too much for public assistance, but too little to afford private coverage. "It's unacceptable that these families play by the rules, pay their taxes and earn a living, but still don't have access to affordable health care for their children. The All Kids program isn't free, parents have to pay into the program, but at rates they can afford."

Though Illinois has been particularly active in outreach and has simplified enrollment procedures for its public coverage programs, certain barriers—such as lack of public awareness and language barriers—contribute to the large number of eligible but uninsured children in the state.[1] With All Kids, the state will aggressively target rural communities as well as areas where English is not the primary language. All Kids pre-registration forms are currently available online and by request from the telephone hotline in 13 languages.

The All Kids benefit package includes doctor visits, hospital stays, prescription drugs, vision care, dental care, and medical devices such as eyeglasses and asthma inhalers. Families will select a primary care physician to provide regular check-ups and immunizations. The hope is that All Kids not only will improve children's health, but their learning as well. Glunz says that "evidence shows that kids with health insurance attend more often and perform better in school because they are actually able to attend more school, they can see the chalkboard more clearly, hear better because they have treated ear infections and have a higher quality of life."

The state estimates that 50,000 children will be enrolled in All Kids during the first year, at a cost of $45 million to the state. This will be funded from an expected $56 million in savings from implementing a primary care case management/disease management model for most of the participants in the state's Medicaid program. Governor Blagojevich expects approximately 204,000 children to be enrolled in All Kids by the fifth year, with savings projected to nearly offset program costs at that time. Illinois estimates the annual cost of All Kids will be $96 million, countered by savings of $93 million from moving beneficiaries to managed care. The state also hopes that this investment will help reduce expensive hospitalizations among children.

According to Glunz, "we know that when a child doesn't receive proper preventive care through regular doctor visits, dental exams, and vision screenings, small medical problems balloon into big problems that eventually lead to more costly care, including emergency room visits."

Reference
[1] For example, Illinois ranked second in the U.S. for enrolling children into the State Children's Health Insurance Program in 2004. (Smith V, Rousseau D. "SCHIP Enrollment in 50 States: December 2004 Update," Kaiser Commission on Medicaid and the Uninsured, September 2005.)