The Blago Giveth, And The Blago Taketh Away: Examining Blagojevich’s Health Care Record

blagallkids.jpg Before a wiretap revealed that Gov. Rod Blagojevich (D-IL) had attempted to “strip a Chicago children’s hospital of $8 million in state money after a hospital executive declined to make a $50,000 contribution,” Blagojevich ‘s health care reform — All Kids — was the apple of every advocate’s eye.

Implemented in July of 2006, All Kids made Illinois “the first state in the nation to offer health coverage to all children.” The program “increased health coverage for children by increasing enrollment of children who are already eligible for Medicaid and SCHIP and giving parents with “higher incomes an opportunity to buy health insurance coverage for their children.”

In many ways, the initiative proved to be national model for reform. To deter employers from “dropping dependent coverage and families from dropping private coverage to enroll their children in All Kids,” the state imposed a 12-month uninsurance waiting period for children in families with income over 200 percent of the federal poverty line. All Kids set no cost sharing for preventive care regardless of income and established sufficiently high premiums for higher-income families to prevent the program from crowding out private coverage.

One component of All Kids also implemented a “primary care case management for all children enrolled in Medicaid and SCHIP,” ensuring that children had access to immunizations and regular checkups. In fact, an August 2007 Kaiser Foundation report observed that financing for the All Kids expansion came largely from from projected savings from the new primary care component and a disease management (DM) program. “Combined, the PCCM and DM are estimated to save $57 million each year, which would cover the first-year costs of the All Kids program, estimated at $25 million,” Kaiser reported.

Building on this program, “the governor proposed the comprehensive Illinois Covered plan to extend coverage to the state’s 1.4 million uninsured adults.” After the funding mechanism for the proposal (a gross receipt’s tax) “came up against opposition from the legislature, the governor scaled back the reform measures” and attempted to use his “administrative powers to add more people to the state’s FamilyCare insurance program.”

Although the governor’s expansion of FamilyCare was thrown out in court, “the state has enacted two helpful health care initiatives” expanding the All Kids health insurance program to 19-and 20-year-olds and requiring hospitals “to offer discounts to uninsured Illinoisans” below a certain percentage of the poverty line.