Illinois' New Health Insurance Program for Children To Debut

Armen Hareyan's picture
Advertisement

Illinois Health Insurance for Children

Physician groups have raised "serious concerns" that Illinois is not prepared for the July 1 launch of All Kids - the new state health insurance program for children - and that problems with implementation of the program will affect access to care for children, the Chicago Tribune reports (Graham/Meyer, Chicago Tribune, 6/30).

Advertisement

All Kids will allow parents of uninsured children to pay a monthly income-based premium for health insurance that in most cases will cost less than private health coverage. Gov. Rod Blagojevich (D) has proposed to shift 1.6 million beneficiaries enrolled in KidCare, FamilyCare and traditional Medicaid to a managed care system for an estimated savings of $56 million in the first year to fund All Kids. By the fifth year, Blagojevich said that he expects enrollment of 204,000 children in All Kids at an annual cost of $96 million, compared with estimated savings of $93 million from the shift to a managed care system in other state health insurance programs (Kaiser Daily Health Policy Report, 6/14). State officials expect 50,000 children to enroll in All Kids in the first year, and about 43,000 have enrolled to date (Keith, AP/Chicago Sun-Times, 6/30). According to the Tribune, a "growing dissatisfaction ... with late payments by Illinois' Medicaid program" among physicians "could discourage physicians from taking on new patients under All Kids." The state Medicaid program has about $1.5 billion in outstanding reimbursement claims, some with delays of more than six months. The state has said that physicians who participate in All Kids will receive reimbursements within 30 days, but "doubts are widespread, the Tribune reports.

Other Concerns
Physicians also have raised concerned about the addition of new patients through All Kids with a new disease management program for 160,000 Medicaid beneficiaries with chronic conditions also scheduled to begin on July 1. In addition, the state next year will require "primary care case management," in which primary care physicians oversee most medical care, for 1.2 million Medicaid beneficiaries. According to the Tribune, "experts question whether Illinois is ready to make good on its promise of health care for all children while simultaneously implementing" the two Medicaid programs.

Comments
Peter Eupierre, president of the Illinois State Medical Society, said, "We are extremely, extremely worried about whether the program will run smoothly enough to allow access to care." He added, "We would like to know, if we need to make a referral, how will that work? What number will we have to call? Will we have to fax documents? Will we have to discuss the case with someone from the state? ... None of those details are available yet, and that's frustrating." Earl Pescatore, president of the Illinois Osteopathic Medical Society, said, "The state has promised (medical) providers time and time again that it will pay our bills promptly, and they just don't do it." He added, "My sense is (state officials are) doing the best they can. But are they ready? No, I really don't think so. I strongly suspect that many bumps lie ahead." Donna Thompson - CEO of Access Community Health Network, which treats about 200,000 patients annually through 45 clinics - said, "In many of our sites we have capacity, and we're fully committed to expanding our hours if we have to serve more families because of All Kids." Anne Marie Murphy, director of the state Medicaid program, said, "We're pretty well prepared," adding, "We know how to do expansions" (Chicago Tribune, 6/30).

Advertisement