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The Basics Healthy Illinois is a proposal for the state to: - PDF document

The Current System is not a System. To do nothing is not an option. Adequate Health Care Task Force March 29, 2006 Prepared by Citizen Action/Illinois The Basics Healthy Illinois is a proposal for the state to: December 2005 Working in


  1. The Current System is not a System. To do nothing is not an option. Adequate Health Care Task Force March 29, 2006 Prepared by Citizen Action/Illinois The Basics Healthy Illinois is a proposal for the state to: December 2005 ▲ Working in partnership with private insurers, use the purchasing power of a massive risk pool to establish a statewide health insurance plan . ▲ Implement reasonable measures to control costs . ▲ Initiate new strategies for quality improvement . Prepared by Citizen Action/Illinois Graham, Judith, “An Endless Wait for Health Care,” Chicago Tribune, Sunday Dec 25, 2005 Parsons, Christi, “Parents Roll Dice on I nsurance,” Chicago Tribune, Monday Dec 05, 2005 H EALTHY I LLINOIS H EALTHY I LLINOIS: An Integrated Approach Healthy Illinois, working alongside existing state programs like FamilyCare, KidCare, and All Kids, would make quality, affordable healthcare available to every man, woman, and child in Illinois. Prepared by Citizen Action/Illinois www.healthyillinoisplan.com 1

  2. Healthy Illinois Is Voluntary H EALTHY I LLINOIS ▲ Individual and small business participation is voluntary. ▲ Businesses and individuals can keep their current coverage if they so choose. Prepared by Citizen Action/Illinois Prepared by Citizen Action/Illinois H EALTHY I LLINOIS: Affordability Individuals and Small Groups ▲ Small businesses would be charged only 50% of the premium. ▲ Small businesses, including not-for-profits ▲ Discounts would enable individuals to join ▲ Small municipalities the Healthy Illinois Plan according to their ability to pay. ▲ Self-employed ▲ A single individual earning less than $27,930 ▲ Individuals and a family of four earning less than ▲ No pre-existing condition exclusion $56,500 would be eligible for discounts. Prepared by Citizen Action/Illinois Prepared by Citizen Action/Illinois Comprehensive coverage will How much will it cost? include, at a minimum: ▲ Revenue generated by assessment = ▲ Hospitalizations $400,000,000 ▲ Individual and Employer Discounts in year ▲ Mental Health one = $192,000,000 (50,000 enrollees @ ▲ Prescription drugs $3,840 discount per year) ▲ Administrative = $100,000,000 in year one ▲ Preventive Care, including routine doctor’s visits and disease screenings ▲ Reserve = $108,000,000 Prepared by Citizen Action/Illinois Prepared by Citizen Action/Illinois www.healthyillinoisplan.com 2

  3. Single mother earning H EALTHY I LLINOIS $32,000/year (250% FPL) • Total premium = $400 per month for employee only • Employer Discount (50%) = ($200 per month) • Employer Pays (60%) = $120 per month • Employee Discount (40%) = ($48 per month) • Employee Pays = $72 per month Prepared by Citizen Action/Illinois Prepared by Citizen Action/Illinois Key Cost Containment Measures The Added Cost of Care for the Uninsured ▲ Review of insurance rates. ▲ Ensure healthcare facilities’ major expansions are $1,059 consistent with state health goals. ▲ Reduce the unpaid cost of care for the uninsured, thereby limiting the degree to which such costs are passed on to consumers with health insurance. In Illinois, over $1.8 billion passed on to consumers with health insurance in 2005. ▲ Public reporting of providers’ and insurance companies’ cost increases and profits. Uncompensated Care : $ 1,059 Total Family Premium : $ 11,762 Prepared by Citizen Action/Illinois (Families USA, June 2005) Illinois Quality Forum – H EALTHY I LLINOIS Quality Improvement Functions Promote nationally established best practices to ▲ eliminate some of the regional, economic, and racial disparities in the healthcare system. Establish incentives for consumers to adopt ▲ healthier lifestyles: health club discounts, 100% coverage of preventive care, smoking cessation programs. Prepared by Citizen Action/Illinois Prepared by Citizen Action/Illinois www.healthyillinoisplan.com 3

  4. Funding Sources ▲ Employer contributions H EALTHY I LLINOIS : Financing ▲ Individual contributions ▲ Windfall Profit Assessment Prepared by Citizen Action/Illinois Prepared by Citizen Action/Illinois Windfall Profit Assessment N EXT S TEPS ▲ Insurance companies pass on to consumers the unpaid cost care for the uninsured (“uncompensated care”). In Illinois, insurance companies inflate premiums by 9-10% to reimburse themselves for uncompensated care. ▲ Meetings with stakeholders ongoing. ▲ Under Healthy Illinois, the cost of uncompensated care will be reduced because more people will have health ▲ SB 2561 is on second reading in the Senate. insurance. Deadline extended to January 9, 2007. ▲ Insurance companies will continue to charge the inflated premium and thus will enjoy an unexpected profit (“a ▲ My contact info: 312-427-2114 xt. 114, windfall”). brent@citizenaction-il.org A portion of the insurance companies’ windfall will be ▲ used to help fund discounts for lower income people. This assessment is known as the “Windfall Profit Assessment.” Prepared by Citizen Action/Illinois Prepared by Citizen Action/Illinois www.healthyillinoisplan.com 4

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