FamiliesUSA Sheds Light on the ACA
The Affordable Care Act (ACA) and the health care reform it brings can be difficult to understand. FamiliesUSA has recently made it a bit easier to understand by making available two different resources.
In a partnership with Herndon Alliance and Anzalone Liszt Research, FamiliesUSA started conducting research to identify the most frequent questions surrounding the ACA. The project began by polling state advocates across the country to find out the most often asked, but also most difficult to answer, questions. The result is a series of Q&A’s that help to de-mystify these common questions. The 10-page document, entitled “Mastering the 30-Second Sound Byte,” offers up straightforward, comprehensive information. In an effort to pass on some of that information to you, our readers, Illinois Health Matters will be posting a series of summaries from the document.
One of the Families USA Q&A’s sheds light on the claim that the ACA does not cut health care costs sufficiently. The answer explains that the ACA does put emphasis on providing good, quality care to citizens, but that it also employs cost-saving measures that do not detract from that quality, for both citizens and those funding health care. One element to this is the free preventative care that the ACA guarantees. Although there will be costs to insurance companies in order to pay for the preventative care in the short term, in the long run, it will end up saving costs from hospital visits and medical care for health conditions that will be detected and treating conditions before they grow serious enough to require more expensive treatment. Thus, both the consumer and the insurance companies are able to save money and still receive and provide quality care. A different step, on the administrative side, is to weed out fraud and abuse from Medicare.
A primary way that costs will be reduced for the consumer is through the health care exchange, a competitive health care marketplace that will be created in each state. The marketplaces will work to allow consumers to easily compare and find the best plan, while providing a competitive incentive for insurance companies to keep costs down. As the FamiliesUSA document describes it, it’s like “comparing airfare at a travel website like Travelocity.”
Finally, long-term efforts to lower costs and to increase quality of care turn towards innovation and ingenuity. The ACA will draw on new ideas from policy specialists that are as of yet untested, and to set up trials in order to see if these ideas will actually operate effectively. If the ideas are successful in test trials, they will be implemented widely in efforts to improve health care for all—without increasing costs!
Annika Yates
Illinois Health Matters
Thursday, 4 August 2011
Monday, 1 August 2011
Illinois General Assembly Taking on Immensely Important Task: Creating Competitive Health Insurance Marketplace
The stage is set for the Illinois General Assembly to complete one of the most important tasks of its members’ legislative lifetimes: creating the competitive health insurance marketplace (officially called the Illinois Health Benefits Exchange) to begin operations in January 2014.
Recently enacted Illinois Public Act 97-0142 calls for the creation of a 12-member Legislative Study Committee tasked with reporting to the General Assembly and the Governor by September 30, 2011, on implementation and establishment of a centralized marketplace where individuals and small businesses can shop for affordable health insurance, qualify for public subsidies to purchase insurance, or be enrolled in public programs (Medicaid or All Kids). The full General Assembly will take up the Exchange legislation during the fall veto session, which begins October 26.
The leaders of the General Assembly should immediately appoint members to the Study Committee—legislators who understand that establishing this marketplace is extremely important to millions of Illinois residents (including the 1.7 million currently without insurance) and small businesses.
Once appointed, the Study Committee members need to educate themselves on what the different and better world of health insurance will be like in 2014. For starters, they need to recognize that by 2014 (sooner in some cases) due to insurance market reforms required by the federal Affordable Care Act, all health insurance companies must:
Recently enacted Illinois Public Act 97-0142 calls for the creation of a 12-member Legislative Study Committee tasked with reporting to the General Assembly and the Governor by September 30, 2011, on implementation and establishment of a centralized marketplace where individuals and small businesses can shop for affordable health insurance, qualify for public subsidies to purchase insurance, or be enrolled in public programs (Medicaid or All Kids). The full General Assembly will take up the Exchange legislation during the fall veto session, which begins October 26.
The leaders of the General Assembly should immediately appoint members to the Study Committee—legislators who understand that establishing this marketplace is extremely important to millions of Illinois residents (including the 1.7 million currently without insurance) and small businesses.
Once appointed, the Study Committee members need to educate themselves on what the different and better world of health insurance will be like in 2014. For starters, they need to recognize that by 2014 (sooner in some cases) due to insurance market reforms required by the federal Affordable Care Act, all health insurance companies must:
- offer insurance to all applicants (no rejections due to health status or pre-existing health conditions),
- set rates based on applicants’ age, geographic location, and smoking status (no charging women or sick people more),
- spend most of the premiums they collect on health care, not on administration, and
- cover preventive health services with no deductible or co-payments, cover care in approved clinical trials, and have no lifetime or annual limits on coverage.
Come 2014, most Americans will be required to have health insurance; that means some 25 million new customers for insurers. The federal government will subsidize the purchase of insurance by people under 400% of the Federal Poverty Level (that’s $43,560 per year for one person and $89,400 for a family of four), and all citizens (and some non-citizens) with incomes under 133% of the Federal Poverty Level will be eligible for Medicaid. Insurers will be able to put their energies into competing by offering the best value and highest quality to customers rather than into avoiding insuring people with health problems, rescinding coverage, or not renewing policies when people file insurance claims.
Study Committee members also need to recognize that the Exchange is about both private health insurance and public health insurance programs. On the private insurance side, the Exchange needs to make it easy for individuals and small businesses to compare health plans, find out if they are eligible for subsidies, and enroll in a health plan that meets their needs. On the public side, the exchange needs to screen people seeking health coverage for eligibility for Illinois public health programs (Medicaid and All Kids), verify their eligibility, and enroll them and reach out to those newly eligible for Medicaid.Committee members need to understand what the U.S. Department of Health and Human Services (HHS) expects from and offers to the states regarding exchanges, most of which is set out in the newly issued proposed rules announced by HHS head, Kathleen Sebelius, on July 11, 2011.
The Study Committee members also need to get up to speed on the substantial work already done or in progress in Illinois:
Study Committee members also need to recognize that the Exchange is about both private health insurance and public health insurance programs. On the private insurance side, the Exchange needs to make it easy for individuals and small businesses to compare health plans, find out if they are eligible for subsidies, and enroll in a health plan that meets their needs. On the public side, the exchange needs to screen people seeking health coverage for eligibility for Illinois public health programs (Medicaid and All Kids), verify their eligibility, and enroll them and reach out to those newly eligible for Medicaid.Committee members need to understand what the U.S. Department of Health and Human Services (HHS) expects from and offers to the states regarding exchanges, most of which is set out in the newly issued proposed rules announced by HHS head, Kathleen Sebelius, on July 11, 2011.
The Study Committee members also need to get up to speed on the substantial work already done or in progress in Illinois:
First, they need to review the Illinois Health Care Reform Implementation Council Initial Report (March 2011). The Implementation Council, established by Governor Quinn, was comprised of the heads of the several Illinois state agencies responsible for various aspects of federal health reform. In 2010 and early 2011, it held meetings around the state to hear from legislators, medical providers, individuals, and organizations on how to best implement the federal reforms, including the Exchange. The report contains detailed recommendations regarding the Exchange (most importantly, that Illinois establish its own Exchange as a quasi-governmental agency with power to negotiate with insurers and require them to compete on price and quality to sell on the Exchange), with accompanying discussion and summaries of the positions of various interests.
Second, they need to examine carefully Illinois Senate Bill 1729, the Illinois Health Coverage Exchange Act. It was the product of months of Department of Insurance-convened open meetings of five stakeholder working groups (patient and family advocates, employers, insurers, providers, and insurance agents). These groups met separately and then together on the key issues of Exchange governance options, operating models, and financing options. S.B. 1729 was based on all that thoughtful input. Study Committee members should also visit the Illinois Department of Insurance’s website pages on Health Insurance Reform, where they will find much important background information on Exchanges and statutes from other states.
Third, on the public programs side, the Department of Healthcare and Family Services (HFS) is moving ahead in developing the automated processes for screening people for eligibility for Medicaid and All Kids, verifying their eligibility, and enrolling them in the appropriate program via the Exchange. The Study Committee needs to invite HFS Director Julie Hamos to give a detailed briefing on those activities.
Finally, the Study Committee can learn from other states that are going down the same road—some far ahead of Illinois. The Study Committee should take advantage of all these existing reports and resources and should use its approximately 10 weeks to drill down into the issues, perhaps by inviting recognized experts to meet with it to answer questions members may have and debate various options. And, of course, it should allow the public to describe their needs and express their opinions.
What it should not do is start from scratch, ignoring the work of the Council, the state agencies, and the input of the hundreds of individuals and organizations who already have participated in good faith in earlier processes. Its September 30 report should aim to educate the entire General Assembly about the importance of this competitive health insurance marketplace. It should be based on facts and sound economic and policy analysis, should explain the reasons for the policy choices that underlie its recommendations, and should include any substantial conflicting evidence, so that General Assembly members can have a full and fair understanding of the choices they will be making in passing Exchange legislation.
Margaret Stapleton
Originally posted here in the Shriver Brief.
Thursday, 28 July 2011
Illinois Starts Work On Health Care Reform
Looking forward to seeing her son one evening, Maurine Magliocco of Springfield got a call saying he had fallen ill and wasn’t going to come. He was debating going to the emergency room. Even though Peter Magliocco, a 28-year-old, had his own insurance, he didn’t think he could afford the trip.
As a concerned mother, Magliocco says she insisted that he go anyway, even if it meant she would cover the cost of the emergency room tests and procedures out-of-pocket.
“It made me realize … we could end up using all of our retirement savings taking care of our kids.”
Magliocco’s dilemma is common, yet there are alternatives on the way under the federal government’s health care insurance reforms. Josephine Underwood is Health Care Justice Campaign downstate organizing coordinator at Illinois Campaign for Better Healthcare (CBHC), the state’s largest grassroots health care coalition. She says individuals like Magliocco will be able to pick from insurance options with more opportunities for preventive care, which can offset the need for emergency care, and/or extended insurance coverage from parents who can have young adults up to age 26 stay on their plan.
Under the Patient Protection and Affordable Care Act, (ACA) each state can create and regulate its own health reform, or it can allow the federal government to run it, according to Kate Gross, assistant director for health planning at Illinois Department of Insurance.
“In these tough economic times, people want to make smart choices, they want to protect their family or protect their small business, but they don’t know how to do that right now because the market is very unhelpful for consumers,” Gross says.
Recently approved Illinois legislation sets up a 12-member legislative study committee to recommend a structure for the Illinois Health Benefits Exchange, which is essentially a competitive health care marketplace. The committee will look into issues like operation, structure and amount of power of the exchange, such as how independent it will be from state government, Gross says. The study committee must submit its report to the Illinois General Assembly and to the governor by Sept. 30.
In order for Illinois to receive full funding from the federal government through 2014, the exchange must be approved by law by June 2012, Gross says. Although partial funding is available, she says full funding is “absolutely critical.” The exchange will be set up online for consumers to compare insurance coverage plans on a website similar in structure to travel websites like Expedia or Travelocity.
Underwood says the tight deadlines are cause for concern, especially if those appointed to the committee take advice from special interest groups instead of from consumers.
“It’s not that the insurance industry shouldn’t be heard… but we really believe that it’s the consumer voice that should be at the foreground,” she says.
To encourage the consumer voice, CBHC held forums with citizens and organizations last year, compiling a list of principles that consumers want to see within the exchange. More forums will take place this summer, in an effort to educate consumers, including those who are frustrated or apathetic about health reform.
“If we were to have a concern, it’s not necessarily to mobilize or to get consumer voices heard, it’s more dealing with that sense of political exhaustion and political hopelessness,” she says.
Magliocco, vice president of the retirees chapter at University Professionals of Illinois, became a CBHC volunteer after sharing her own story. She says consumers don’t need to understand legislative policy to get involved.
“What they don’t realize is that what they need to do is just to tell their stories and the stories of the people that they know,” she says.
Hannah Douglas
Originally published in The Illinois Times
Contact Hannah Douglas at hdouglas@illinoistimes.com
For an example of another state’s health exchange that’s already implemented, visit Massachusetts’ exchange site: www.mahealthconnector.org.
As a concerned mother, Magliocco says she insisted that he go anyway, even if it meant she would cover the cost of the emergency room tests and procedures out-of-pocket.
“It made me realize … we could end up using all of our retirement savings taking care of our kids.”
Magliocco’s dilemma is common, yet there are alternatives on the way under the federal government’s health care insurance reforms. Josephine Underwood is Health Care Justice Campaign downstate organizing coordinator at Illinois Campaign for Better Healthcare (CBHC), the state’s largest grassroots health care coalition. She says individuals like Magliocco will be able to pick from insurance options with more opportunities for preventive care, which can offset the need for emergency care, and/or extended insurance coverage from parents who can have young adults up to age 26 stay on their plan.
Under the Patient Protection and Affordable Care Act, (ACA) each state can create and regulate its own health reform, or it can allow the federal government to run it, according to Kate Gross, assistant director for health planning at Illinois Department of Insurance.
“In these tough economic times, people want to make smart choices, they want to protect their family or protect their small business, but they don’t know how to do that right now because the market is very unhelpful for consumers,” Gross says.
Recently approved Illinois legislation sets up a 12-member legislative study committee to recommend a structure for the Illinois Health Benefits Exchange, which is essentially a competitive health care marketplace. The committee will look into issues like operation, structure and amount of power of the exchange, such as how independent it will be from state government, Gross says. The study committee must submit its report to the Illinois General Assembly and to the governor by Sept. 30.
In order for Illinois to receive full funding from the federal government through 2014, the exchange must be approved by law by June 2012, Gross says. Although partial funding is available, she says full funding is “absolutely critical.” The exchange will be set up online for consumers to compare insurance coverage plans on a website similar in structure to travel websites like Expedia or Travelocity.
Underwood says the tight deadlines are cause for concern, especially if those appointed to the committee take advice from special interest groups instead of from consumers.
“It’s not that the insurance industry shouldn’t be heard… but we really believe that it’s the consumer voice that should be at the foreground,” she says.
To encourage the consumer voice, CBHC held forums with citizens and organizations last year, compiling a list of principles that consumers want to see within the exchange. More forums will take place this summer, in an effort to educate consumers, including those who are frustrated or apathetic about health reform.
“If we were to have a concern, it’s not necessarily to mobilize or to get consumer voices heard, it’s more dealing with that sense of political exhaustion and political hopelessness,” she says.
Magliocco, vice president of the retirees chapter at University Professionals of Illinois, became a CBHC volunteer after sharing her own story. She says consumers don’t need to understand legislative policy to get involved.
“What they don’t realize is that what they need to do is just to tell their stories and the stories of the people that they know,” she says.
Hannah Douglas
Originally published in The Illinois Times
Contact Hannah Douglas at hdouglas@illinoistimes.com
For an example of another state’s health exchange that’s already implemented, visit Massachusetts’ exchange site: www.mahealthconnector.org.
Monday, 18 July 2011
An Exchange Is Coming Your Way!
After months of negotiation, Governor Quinn on Friday signed SB 1555, the piece of legislation that will establish the Illinois Health Benefits Exchange. The bill’s passage marks a tremendous step in moving forward the Affordable Care Act in Illinois.
That’s because the new law (known as Public Act 097-0142) will make Illinois the 13th state to begin to build a health benefit exchange, which is the cornerstone of healthcare reform. An exchange - also known as a competitive healthcare marketplace – will primarily let individuals and employees of small businesses shop for a range of affordable health insurance choices, and will give lower and middle-income uninsured Americans more affordable insurance options.
When fully in place, exchanges will provide access to health insurance for 24 million Americans, says Timothy Jost, a professor of law at Washington and Lee University. In Illinois, 11 percent of the insured, nonelderly population (roughly 1.1 million) will have coverage through the exchange by 2016, according to a recent RAND report.
How will exchanges work?
Consumers will shop online on a website that will look similar to Consumer Reports or Travelocity. They’ll have access to easy-to-understand information to make real comparisons between plans so they can find the one that best meets their needs and budget. The site will be closely monitored to prevent fraud and protect consumers, and members of Congress also will be required to get their insurance through this marketplace—giving them the same options as millions of Americans for the first time ever.
An exchange will give Illinois consumers more control, quality choices, and better protections when purchasing insurance for themselves, their families and their small businesses. This is definitely a step forward for Illinois consumers.
What’s in the bill?
As legislation goes, SB 1555 is a short bill that establishes the exchange as well as the option of health savings accounts for state employees. Here are four key action items for the exchange in Illinois that we’ll see put into place in coming weeks and months.
1. The state of Illinois will run its own exchange rather than having the Federal government run it. This comes as no surprise: The Quinn administration has stated in the past that it believes state control is in the best interest of of employees and families in Illinois, and will give Illinoisans better oversight and consumer protection.
2. Illinois will create a Legislative Study Committee that will conduct a study on how to best implement and establish the exchange. Each party leader in the House and Senate may appoint three of their members to this twelve-member Committee, who will make decisions on key aspects of the exchange, including the size of the employer to be offered coverage and the development of standards for employee coverage. The report detailing the results of the study must be completed in less than 90 days (September 30, 2011).
3. The exchange will separate the coverage pools for individuals and small employers of up to 50 employees. Consumer advocates had recommended that the exchange merge the two pools, which could result in lower or more stable premium costs. The Department of Insurance has hired a consultant to study the existing Illinois health insurance marketplace so it remains to be seen what the impact is of merging or separating the coverage pools.
4. The Illinois Department of Insurance and the Commission on Government Forecasting and Accountability is authorized to apply for and receive federal grant money to meet the October 1, 2013 deadline to have an operational health benefits exchange. This is a critical move, as it will allow Illinois to proceed as planned without forcing the conversation of whether state budget dollars should be allocated to establish the exchange.
What's next for consumers and small businesses?
If you haven't gotten involved in the implementation of the Affordable Care Act in Illinois, now is the time to start. First, you’ll want to learn more about whether the exchange will affect you. The Kaiser Family Foundation has put together a nice flowchart.
You can also attend the Legislative Study Committee meetings (we'll post the dates of the public meetings on Illinois Health Matters). Important decisions will be made that could affect how you, your business or your family will purchase health insurance.
Furthermore, you may want to contact your state senator or representative and tell them what you want out of an exchange, such as good governance and high-quality health plans. Check out these talking points from Community Catalyst.
Above all, check back on our site as we continue to closely monitor the Illinois Health Benefits Exchange news and how it impacts you, your business and your family. Sign up for our newsletter, facebook page and twitter feed for up-to-date information.
Stephani Becker
Health & Disability Advocates, the public-private partnership that powers Illinois Health Matters
Wednesday, 13 July 2011
New Report Confirms that Medicaid Matters for Americans
The August deadline to negotiate a deficit reduction package is on the horizon. As many already know, the discourse seems to have boiled down to this weighing of Medicaid costs versus the justness of taxing the wealthiest Americans. In an attempt to break the legislative stalemate, President Obama offered to cut billions in Medicaid spending if Republican leaders would make concessions on the tax issue. It wasn’t a shocking offer, Medicaid has long been the victim of budget cuts, and this year is no different. However, a well timed, landmark study on the actual impact of Medicaid has made the detriment of this decision more clear than ever.
Just last week researchers from Harvard School of Public Health, Massachusetts Institute of Technology, the National Bureau of Economic Research and Providence Health & Services released the results of the Oregon Health Insurance Experiment, which unequivocally demonstrates the value of the Medicaid program. This landmark study is the first ever randomized-control trial of Medicaid—the gold standard of scientific research. The Experiment concludes that expanding access to Medicaid “substantially increases health care use, reduces financial strain on covered individuals and improves their self-reported health and wellbeing.”
We cannot overlook the relevance of this study in the current political and economic context. In Illinois alone, 1.8 million children, adults, elderly, and people with disabilities are covered by this safety net program. That is 14% of the population. Cutting Medicaid means that thousands of people will be forced to go without basic medical assistance. Even worse, it means those who must access care could face financial ruin in the face of ballooning healthcare costs and much of the risk will fall back on working class Americans.
Illinois Maternal and Child Health Coalition has always stood in support of Medicaid beneficiaries and this study supports what we have been saying for a long time--MEDICAID MATTERS! We must seize the excellent timing of this report and become even more adamant in our demands that legislators take a responsible approach to the deficit that does not fall on the backs of the most vulnerable Americans. Take action today and help us to make the message clear--Medicaid matters!
Kathy Waligora
Illinois Maternal and Child Health Coalition
(Originally posted here.)
Just last week researchers from Harvard School of Public Health, Massachusetts Institute of Technology, the National Bureau of Economic Research and Providence Health & Services released the results of the Oregon Health Insurance Experiment, which unequivocally demonstrates the value of the Medicaid program. This landmark study is the first ever randomized-control trial of Medicaid—the gold standard of scientific research. The Experiment concludes that expanding access to Medicaid “substantially increases health care use, reduces financial strain on covered individuals and improves their self-reported health and wellbeing.”
We cannot overlook the relevance of this study in the current political and economic context. In Illinois alone, 1.8 million children, adults, elderly, and people with disabilities are covered by this safety net program. That is 14% of the population. Cutting Medicaid means that thousands of people will be forced to go without basic medical assistance. Even worse, it means those who must access care could face financial ruin in the face of ballooning healthcare costs and much of the risk will fall back on working class Americans.
Illinois Maternal and Child Health Coalition has always stood in support of Medicaid beneficiaries and this study supports what we have been saying for a long time--MEDICAID MATTERS! We must seize the excellent timing of this report and become even more adamant in our demands that legislators take a responsible approach to the deficit that does not fall on the backs of the most vulnerable Americans. Take action today and help us to make the message clear--Medicaid matters!
Kathy Waligora
Illinois Maternal and Child Health Coalition
(Originally posted here.)
Friday, 1 July 2011
Illinois Could Create a Whole New Competitive Health Care Marketplace
Earlier this week, a new report was released that highlights how Illinois policy makers can address rising health care costs by implementing an effective health insurance exchange. The federal reform law requires states to create health insurance exchanges and can improve health care and lower costs by pooling consumers’ bargaining power.
Fortunately, the federal law allows Illinois leaders the flexibility to craft an exchange that enhances choice and competition. The report, Building a Better Health Care Marketplace, details the steps policy-makers must take to ensure that the exchange lives up to its promise.
To succeed, this new health insurance marketplace must be run by and for Illinois businesses and consumers, not by and for the insurance lobby. It needs to have the power to negotiate for lower premiums and push for reforms that improve the quality of care. It needs to be consumer friendly. And it needs to be big and stable. As Illinois policymakers create our exchange, they should focus on delivering results for consumers.
Senate Bill 1555, passed by the Illinois General Assembly last month, would create a legislative committee to further evaluate and make final recommendations by September 30th on how best to set up an Illinois health insurance exchange. The bill still must be signed into law by Governor Quinn.
Insurers and other special interests will try to undermine the exchange by preventing it from negotiating and keeping consumers in the dark about the value of their coverage. But our leaders have to stand up for consumers. Making the health care marketplace more competitive is the best opportunity we have to give consumers more power and lower costs.
Brian Imus
Illinois PIRG the Illinois Public Interest Research Group
For more on Illinois PIRG’s Making Health Care Work Campaign click here.
Connect with us on Facebook.
Fortunately, the federal law allows Illinois leaders the flexibility to craft an exchange that enhances choice and competition. The report, Building a Better Health Care Marketplace, details the steps policy-makers must take to ensure that the exchange lives up to its promise.
To succeed, this new health insurance marketplace must be run by and for Illinois businesses and consumers, not by and for the insurance lobby. It needs to have the power to negotiate for lower premiums and push for reforms that improve the quality of care. It needs to be consumer friendly. And it needs to be big and stable. As Illinois policymakers create our exchange, they should focus on delivering results for consumers.
Senate Bill 1555, passed by the Illinois General Assembly last month, would create a legislative committee to further evaluate and make final recommendations by September 30th on how best to set up an Illinois health insurance exchange. The bill still must be signed into law by Governor Quinn.
Insurers and other special interests will try to undermine the exchange by preventing it from negotiating and keeping consumers in the dark about the value of their coverage. But our leaders have to stand up for consumers. Making the health care marketplace more competitive is the best opportunity we have to give consumers more power and lower costs.
Brian Imus
Illinois PIRG the Illinois Public Interest Research Group
For more on Illinois PIRG’s Making Health Care Work Campaign click here.
Connect with us on Facebook.
Sunday, 26 June 2011
Starting July 1 in Illinois: "Some" Kids Instead of "All Kids"
In 2010, a study conducted by the University of Illinois at Chicago showed that over 95% of Illinois’ kids had insurance coverage, making Illinois a state with one of the lowest rates of uninsured children in the nation. Much of this success can be attributed to the All Kids health insurance program, which provides for affordable, comprehensive health insurance for all Illinois children (up to age 19) who need coverage, regardless of family income or immigration status. Higher-income families pay monthly premiums ranging from $15 - $300/child, along with co-pays for doctor visits and other health care services.
Unfortunately, starting this Friday July 1st, All Kids will only allow for “some kids” to qualify for coverage. Legislation passed by the Illinois General Assembly and signed by the Governor in January places an income cap on the program at the start of July, effectively cutting off eligibility at 300% of the federal poverty level (FPL). This is equivalent to about $5,500/month or $66,000/year for a family of four.
Children enrolled in All Kids at or above 300% FPL by June 30th, 2011 are allowed to continue All Kids coverage for up to 12 months until July 1st, 2012, when NO children above 300% FPL will be allowed to continue their coverage.
While the Illinois Department of Healthcare and Family Services estimates that fewer than 4,000 children are enrolled in All Kids above the income cap, it’s likely that many of these families enrolled their children in All Kids because private insurance was unaffordable or inaccessible or because coverage options were insufficient for their child’s health care needs.
So where does this leave families who will no longer be able to qualify for All Kids?
Families can pursue employer-based insurance or insurance on the individual market. The Affordable Care Act included a provision, effective September 23, 2010, that no longer allows insurance companies to deny children health insurance because of pre-existing conditions.
Some children may be eligible for the Illinois Pre-existing Condition Insurance Plan (IPXP) if they have a pre-existing condition and have been uninsured for at least six months. The Illinois Comprehensive Health Insurance Plan may also be an option for some families.
However, these options may be unaffordable or inaccessible to many families. If this is the case for you or for a family you know, the Illinois Maternal and Child Health Coalition is interested in hearing your story. These stories can help us with advocacy efforts to persuade legislators to revise the changes to All Kids in upcoming legislative sessions. Contact Kathy Chan at kchan@ilmaternal.org or at 312-491-8161 x 24.
Kathy Chan
Illinois Maternal and Child Health Coalition
Unfortunately, starting this Friday July 1st, All Kids will only allow for “some kids” to qualify for coverage. Legislation passed by the Illinois General Assembly and signed by the Governor in January places an income cap on the program at the start of July, effectively cutting off eligibility at 300% of the federal poverty level (FPL). This is equivalent to about $5,500/month or $66,000/year for a family of four.
Children enrolled in All Kids at or above 300% FPL by June 30th, 2011 are allowed to continue All Kids coverage for up to 12 months until July 1st, 2012, when NO children above 300% FPL will be allowed to continue their coverage.
While the Illinois Department of Healthcare and Family Services estimates that fewer than 4,000 children are enrolled in All Kids above the income cap, it’s likely that many of these families enrolled their children in All Kids because private insurance was unaffordable or inaccessible or because coverage options were insufficient for their child’s health care needs.
So where does this leave families who will no longer be able to qualify for All Kids?
Families can pursue employer-based insurance or insurance on the individual market. The Affordable Care Act included a provision, effective September 23, 2010, that no longer allows insurance companies to deny children health insurance because of pre-existing conditions.
Some children may be eligible for the Illinois Pre-existing Condition Insurance Plan (IPXP) if they have a pre-existing condition and have been uninsured for at least six months. The Illinois Comprehensive Health Insurance Plan may also be an option for some families.
However, these options may be unaffordable or inaccessible to many families. If this is the case for you or for a family you know, the Illinois Maternal and Child Health Coalition is interested in hearing your story. These stories can help us with advocacy efforts to persuade legislators to revise the changes to All Kids in upcoming legislative sessions. Contact Kathy Chan at kchan@ilmaternal.org or at 312-491-8161 x 24.
Kathy Chan
Illinois Maternal and Child Health Coalition
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