Illinois poised to insure all kids

But some are wary that program, which begins this week, will be too costly


CHICAGO -- When Illinois Gov. Rod R. Blagojevich signed it last winter, the All Kids program was heralded as the nation's most ambitious plan to ensure that all children would have access to health insurance, regardless of their immigration status.

Now, as the program's benefits began to roll out this week, thousands of families and doctors are wondering whether the broad-reaching effort will live up to its promise.

State officials said the legislation is designed to provide medical, dental and vision visits and prescription drug coverage to those age 18 and younger whose working-class families can't afford private insurance but earn too much to qualify for Medicaid.

Although Illinois was among the first to enact such statewide legislation in recent years, New Mexico and Hawaii have established similar efforts. Massachusetts' new near-universal program includes provisions to increase coverage of uninsured minors. And legislators in at least eight other states are examining proposals that would guarantee affordable coverage for minors.

And as the country heads into a midterm election season, universal coverage for children has broad popular support.

"It's more than just politics, though," said Jocelyn Guyer, a senior program director at the Center for Children and Families at Georgetown University's Health Policy Institute. "Kids not having coverage is a huge problem, and it's only getting bigger."

The goal of Illinois' All Kids is to fill the gap between where the federal government leaves off and where the private sector begins. An estimated 250,000 children in Illinois do not have insurance.

So far, more than 43,000 children have been enrolled in All Kids - coming close to the 50,000 enrollment of previously uninsured kids that the state had targeted for the first year.

How much a family will pay at the doctor's office depends on their income. For example, a family with two children that pulls in about $40,000 would be billed a $10 co-pay for each doctor visit and $80 per month total for the two children, according to program officials.

The program is to be funded by a combination of fees paid by families, federal funds and cuts in other state health care expenses. Part of the costs will be covered by changing how the state's 1.7 million Medicaid patients see their doctors. Instead of visiting any physician on a list, these recipients will be assigned a single doctor, a model patterned after health-management organizations.

"To me, health care is a fundamental human right," Blagojevich said, adding that all parents should have the access to health care he enjoys. "If it's OK for the governor's two young children to have regular visits to the doctors for checkups, then the golden rule teaches us we should do for others as others would do for you."

Yet some critics are wondering whether All Kids, which is expected to cost $45 million in its first year, will be able to deliver on its promise. They fear that the program could end up costing more than expected, a financial burden that could pain an already tight state budget.

"We've seen lots of promises with All Kids and little else," said state Sen. Peter Roskam, a Republican, who has been critical of how the program has been designed. "How much of this is politics, and how much of this is trying to do the right thing?"

Blagojevich, who has turned the program into a cornerstone of his re-election campaign this year, countered: "This is an affordable health care program, not a free one."

Medical professionals have a range of opinions about the program. Some are optimistic - "It's something we've needed for years," said Dr. Mark Rosenburg, past president of the American Academy of Pediatrics - but other medical groups have serious concerns about the program's long-term success.

"We have trouble with the state Medicaid program paying bills on time. We haven't been told if patients are going to know where to go for treatment, or how we're supposed to deal with referrals," said Dr. Peter Eupierre, Illinois State Medical Society president. "There are too many unanswered questions for our comfort."

Blagojevich said that he spearheaded All Kids in response to appeals from voters, who say they cannot afford regular medical checkups for themselves or their kids, and can't afford to get treatment if they get sick.

An estimated 46 million people in America lack health insurance, according to the U.S. Census Bureau, and both states and local governments are finding themselves forced to step in and fill the gap.

P.J. Huffstutter writes for the Los Angeles Times.

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