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Damage to Women and Families Persists in Wake of Budget Impasse

Chicago Foundation for Women, Voices for Illinois Children, and Loyola University Chicago’s Center for Urban Research and Learning today released a new report on the impact of Illinois’ budget impasse on women and children. The report, titled “Damage Done: The Impact of the Illinois Budget Stalemate on Women and Children,” was prepared by Voices for Illinois Children and Loyola’s Center for Urban Research and Learning. Illinois’ most vulnerable residents, including low-income women of color and their children, continue to bear the burden of the state’s two-year impasse, which delayed payment of contracts to social service providers and resulted in significant cuts in staff and services that cannot be quickly replaced.

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2017 Kids Count Report: Illinois Investments Matter

Written by Anna Rowan

Data from the beginning of the state’s budget crisis show that smart investments in children lead to progress. Illinois is currently 19th in the nation in the latest rankings for child well-being, according to the 2017 KIDS COUNT Data Book from the Annie E. Casey Foundation. Yet, the lack of a full state budget for the past two years (and no foreseeable end to the impasse) puts Illinois in danger of undermining its own investments and progress.

2017 KIDS COUNT

Source: Annie E. Casey Foundation

The 2017 KIDS COUNT Data Book uses 16 indicators to rank each state across four domains — health, education, economic well-being, and family and community — that represent what children need most to thrive. Illinois ranks:

  • 10th in health. Illinois has been a national leader in providing children with access to health insurance. From 2010 to 2015, Illinois cut the uninsured rates for African-American and Latino children in half, from 6 percent to 3 percent, for both groups.
  • 13th in education. Early childhood education has been a bright spot for Illinois. Less than half of 3- and 4-year olds do not attend school, ranking the state fifth in this indicator. However, the state still has significant work to do to close the achievement and attainment gaps that exist between low-income and minority students from their white and more affluent peers.
  • 25th in economic well-being. Illinois families continue to struggle with economic security. Although more kids’ parents are now working full-time, year-round jobs than in 2010, the percentage of children living in poverty has not changed when comparing the height of the Great Recession in 2010 to 2015 data.
  • 28th in the family and community domain. Illinois has made great strides in reducing the teen birth rate. There were more than 6,000 fewer teen births in 2015 than in 2010. But there are still far too many children living in high-poverty areas and in single-parent families.

The data show that key investments in health and early education have reduced racial disparities among children. Although Latino children still lag behind in preschool attendance, there is little difference between the percentage of African-American and white children who aren’t attending preschool. Additionally, all groups of kids are accessing health insurance at roughly the same rate. However, there is still work to do to lessen other disparities. For example, more than two-thirds of the half a million Illinois children living in poverty are children of color. If Illinois elected officials fail to enact a budget for a third year, we run the very real risk of causing disparities to grow and wiping out the progress we’ve made.

The 2017 KIDS COUNT Data Book with state-by-state rankings and supplemental data can be viewed at http://www.aecf.org/resources/2017-kids-count-data-book/.

 

Paid Sick Leave Benefits Children’s Health

This month, the Illinois Senate has the opportunity to pass legislation to protect children’s health by providing Illinois workers with paid sick days.

The Healthy Workplace Act (HB 2771) would allow an employee to accrue and use up to five paid sick days per year. Employees may use their paid sick days to care for themselves or a family member. It is an important measure when it comes to children’s health.

Receiving care from their parents is important for children’s mental as well as physical health. Parents have been shown to play important roles in the care of children with chronic and acute conditions such as epilepsy, asthma and diabetes.

Many studies have also shown that a parent’s presence helps with their children’s recovery. When parents are involved in children’s care, children recover more rapidly from outpatient procedures and the duration of hospital stays is reduced by 31%. When parental involvement in the care of sick children is increased, children’s anxiety decreases. On the other hand, separating young children from their parents when they are sick has been shown to have detrimental effects.

While parental involvement is key to the health of children, many parents are forced to decide whether to leave a sick child home alone, send a sick child to school, or stay home with their child and risk losing pay or getting fired because they have no access to paid sick leave. In one study, 58% of working parents continued to go to work when their children were sick. Of the parents who were able to stay home with their children when they were sick, more than half reported that the reason they could stay at home was that they received some type of paid leave. In a separate study conducted in Chicago and Los Angeles, 41% of parents with children with special needs stated that at least once in the past year they went to work even though they felt they should have taken time off to take care of their sick child.

Paid sick leave is important for all working parents but is essential for low-income working mothers, who are primarily responsible for their children’s health. More than half of low-income mothers must take time off when their children are sick compared to a third of higher income mothers. While 71% of higher income mothers have paid sick leave, only 31% of low-income mothers have the same type of support. Among the mothers who do not have other child care options and must miss work when their children are sick, 60% are not paid for that time off.

paid sick leave

 

Lack of paid sick leave compromises the health of all Illinois children. Parents without paid sick days are more than twice as likely as parents with paid sick days to send a sick child to school or day care putting at risk the health of their children and that of other children. On the other hand, parents who have paid sick or vacation leave are more than five times as likely to care for their sick children compared to those without leave shortening the time children are sick and protecting the health of other children.

Helping to ensure parents have the time and the financial resources to take care of their children, paid sick leave safeguards the health of children in Illinois.

Written by Militza M. Pagán
Consultant to Voices for Illinois Children

What do Illinois’ Moms want for Mother’s Day?

How about continued health care coverage?  As of the beginning of this year, there were 1,679,700 women and girls enrolled under the state’s Medicaid program.

Medicaid provides health care coverage to low-income children and their families, pregnant women, persons who are disabled and seniors. In Illinois, the program currently covers approximately 3.1 million people overall. In addition, there are 649,000 Illinoisans are enrolled under the Affordable Care Act (ACA) – 288,464 of them are women.

Most women covered by the state’s Medicaid program are low-income women of color – 28% are African American and 26% are Hispanic. Medicaid covers services related to preventative screenings, maternal health and long-term care affecting senior women – services that impact women inter-generationally. As an example, Medicaid financed 50% of all births in the state of Illinois in 2014. With Medicaid responsible for funding so many services specific to women’s health care, the recent U.S. House passage of the American Health Care Act (AHCA) endangers crucial coverage for Illinois women and their children.

Medicaid and Women 1 - T

The bill is before the U.S. Senate for consideration. The Congressional Budget Office (CBO) estimated that an earlier version of the bill could lead to a loss of coverage nationally of 24 million people nationwide by 2026. The newest version has not been scored by the CBO. However, changes in the bill before the Senate could lead to higher costs and additional loss of coverage.

Fewer Uninsured
Prior to the ACA, eligibility for Medicaid coverage was limited to “children, cash assistance recipients, seniors, and people with disabilities”. The ACA’s Medicaid Expansion allowed 32 states, including Illinois, to include women with incomes at or below 138 percent of the poverty line. With Illinois choosing to opt into the Medicaid Expansion, the number of uninsured women in the state, aged 18 to 44 has dropped from almost 18% to 13.4% in 2016.

uninsured

Those improvements are now at risk.

Overall, the bill cuts $839 billion in federal spending from Medicaid over ten years. One estimate puts Illinois’ potential financial loss over ten years at $40 billion.

Two significant funding changes in the AHCA are lowering the federal matching rate (or Federal Medical Assistance Percentage -FMAP) for new enrollees covered under Illinois’ Medicaid expansion and implementing a spending cap for each enrollee in the state’s Medicaid  program. (In Illinois, if the FMAP falls below 90%, state law requires that coverage ceases at the end of three months following changes in the FMAP.)

Among its other changes, the federal bill allows a state to:

  • waive the ACA’s community rating (which contains a prohibition against charging higher premiums for pre-existing coverage) if it creates a “high risk pool” and
  • waive the “essential health benefits” requirements.

High Risk Pool
How did these high risk pools work in the past?  In the pre-ACA era, they generally led to enrollment caps and unaffordable premiums. While the AHCA has allocated $130 billion in funding for high-risk pools, even if all of the funding were used for these pools, they would still be underfunded by at least $200 billion.

The cost of higher premiums for pre-existing conditions places an undue burden on women. Prior to the ACA, pre-existing conditions included prior C-sections, breast or cervical cancer, receiving medical treatment for domestic or sexual violence, and/or clinical depression. In Illinois, 26% of the population would have had a pre-existing condition that would make  them uninsurable.

Essential Benefits
While essential health benefits vary by state, the ACA provides a floor with a list of benefits that insurers are required to cover. In Illinois, these include: hospitalization, maternity, coverage for prescriptions, pediatric oral and vision coverage and newborn care, as well as preventative services like mammograms and bone density screenings. While the AHCA maintains preventative services for private plans, those requirements would no longer apply to the Medicaid Expansion population, meaning a loss of much needed services by women in that population.

Instead of taking away Mom’s health care coverage, let’s remind our federal officials this week (which is National Women’s Health Week) of the great strides we’ve made under the ACA and the great gift it has provided to Illinois women and their families.

Written by Mayumi Grigsby

Another Threat to Health Care for Illinois Women and Children

If Illinoisans were worried about losing coverage under the last version of the American Health Care Act (AHCA) proposed at the federal level, the latest incarnation will do little to reassure them.[1] Medicaid provides health coverage to low-income children and their families, pregnant women, persons who are disabled, and seniors.[2] The program currently covers 36 percent of Illinois children with a mix of federal and state funds.[3] Approximately 3.1 million people are currently enrolled in Illinois’ Medicaid program and 649,000 are enrolled under the Affordable Care Act (ACA).[4] Seventeen percent of Illinois women are covered by Medicaid.[5]

A reported agreement in the U.S. House of Representatives by the conservative Republican House Freedom Caucus and the moderate Republican Tuesday Group has revitalized the bill that failed to garner enough support at the federal level last month. The newest version keeps the base of the original AHCA bill while adding provisions that would further endanger coverage for vulnerable populations.[6] The previous proposed changes to the ACA, would have led to a loss of medical coverage for 14 million people in 2018.[7]  Changes to the tax subsidies allowing citizens to buy coverage and to the Medicaid program would have increased the number of uninsured from 14 million to 21 million in 2020, and to 24 million in 2026.[8]

The version garnering the endorsement of the House Freedom Caucus adds the following: a) it allows states to waive the ACA’s “community rating” requirements, which is the prohibition against charging people higher premiums for preexisting coverage, so long as the state creates a “federal high risk pool”;  b) it allows states to waive the ACA’s “Essential Health Benefits” standards, which are key services health market plans must cover, such as prescription drugs, mental health treatment and maternity care.[9] In Illinois, these benefits also include pediatric oral and vision coverage for children and coverage for autism spectrum disorders.

States would receive automatic approval for these waivers within 90 days if they attest that their purpose is to lower premiums, improve coverage levels, or advance another benefit to the public interest.[10]

These are significant steps. High-risk pools existed in many states prior to the ACA and they led to “enrollment caps, long waiting lists, unaffordable premiums, exclusions for pre-existing conditions, high deductibles, benefit caps, and annual and lifetime limits on coverage”.[11]

Illinois has existed without a complete budget for almost two years.[12] The state faces a FY 17 revenue shortfall of $5.7 billion and has amassed a backlog of bills totaling more than $13 billion.[13] Delayed payments or actual cuts continue to lead to providers curtailing vital human services.[14]

Under the previous version of the AHCA, Illinois stood to lose $40 billion over a ten-year period. Inaction by the Illinois General Assembly and the Governor to address the state’s revenue shortfall has already threatened services for vulnerable Illinois residents including low-income children and their families, persons with disabilities and seniors. The current changes proposed at the federal level further exacerbate that threat.

Written by Mayumi Grigsby


[1] http://www.chicagotribune.com/news/local/politics/ct-congress-illinois-aca-repeal-met-0316-20170315-story.html
[2] http://www.voices4kids.org/proposed-medicaid-changes-could-mean-end-of-services-for-thousands-in-illinois/
[3] http://www.voices4kids.org/proposed-medicaid-changes-could-mean-end-of-services-for-thousands-in-illinois/
[4] http://www.voices4kids.org/proposed-medicaid-changes-could-mean-end-of-services-for-thousands-in-illinois/
[5] http://kff.org/womens-health-policy/fact-sheet/womens-health-insurance-coverage-fact-sheet/
[6] http://www.cbpp.org/research/health/reported-amendment-to-house-aca-repeal-bill-guts-protections-for-people-with-pre
[7] http://www.voices4kids.org/proposed-medicaid-changes-could-mean-end-of-services-for-thousands-in-illinois/
[8]http://www.voices4kids.org/proposed-medicaid-changes-could-mean-end-of-services-for-thousands-in-illinois/
[9] http://www.cbpp.org/research/health/reported-amendment-to-house-aca-repeal-bill-guts-protections-for-people-with-pre
[10] http://www.cbpp.org/research/health/reported-amendment-to-house-aca-repeal-bill-guts-protections-for-people-with-pre
[11] http://www.cbpp.org/research/health/reported-amendment-to-house-aca-repeal-bill-guts-protections-for-people-with-pre
[12] http://www.voices4kids.org/proposed-medicaid-changes-could-mean-end-of-services-for-thousands-in-illinois/
[13] http://www.cbpp.org/research/state-budget-and-tax/many-states-face-revenue-shortfalls
[14] http://www.voices4kids.org/proposed-medicaid-changes-could-mean-end-of-services-for-thousands-in-illinois/

Paid Sick Leave in Illinois

The Illinois House has passed legislation (HB 2771) that would provide paid sick leave to Illinois workers who currently have no such right.

While Cook County and the City of Chicago have approved ordinances on paid sick leave that become effective July 1, 2017, there are still 1.5 million Illinois workers without the right to paid sick days.

The  Healthy Workplace Act would allow an employee to accrue and use up to five paid sick days per year.

Momentum to provide more workers paid sick leave has been building throughout Illinois and the nation. The City of Chicago and Cook County approved their measures in 2016. That same year, Arizona, Vermont and Washington-passed laws ensuring access to paid sick leave to all workers in their states.  Paid sick leave is also the law in four other states (Connecticut, California, Massachusetts and Oregon).

Jurisdictions with Paid Sick Days[1]
State and District Effective Date of Statutes
Connecticut 2012
Washington DC 2014
California 2015
Massachusetts 2015
Oregon 2016
Vermont 2017
Arizona 2017
Washington 2018
County Effective Date of Statutes
Montgomery County, MD 2016
Cook County, IL 2017
City Effective Date of Statutes
San Francisco, CA 2007
Seattle, WA 2012
New York, NY 2014
Jersey City, NJ 2014
Newark, NJ 2014
Irvington, NJ 2015
Passaic, NJ 2015
East Orange, NJ 2015
Paterson, NJ 2015
Trenton, NJ 2015
Montclair, NJ 2015
Bloomfield, NJ 2015
Oakland, CA 2015
Philadelphia, PA 2015
Emeryville, CA 2015
Pittsburgh, PA 2015
Elizabeth, NJ 2016
Plainfield, NJ 2016
San Diego, CA 2016
Tacoma, WA 2016
New Brunswick, N.J 2016
Los Angeles, CA 2016
Morristown, NJ 2017
Berkeley, CA 2017
Spokane, WA 2017
Santa Monica, CA 2017
Minneapolis, MN 2017
St. Paul, MN 2017
Chicago, IL 2017

What is paid sick leave?

Paid sick leave allows workers to take time off to recover from illness, attend a doctor’s appointment, take care of a sick loved one, or stay home to take care of children when school is canceled without a loss in pay. Workers accrue paid sick days based on the number of hours they work. The more hours an employee works, the more hours they accrue.

What are the benefits of paid sick leave?

Both employers and workers benefit from earned sick leave by reducing turnover, increasing productivity, saving on healthcare costs, reducing the spread of disease, and providing more economic security for workers.

Paid sick leave is good for children. Parents without paid sick days are more than twice as likely as parents with paid sick days to send a sick child to school or day care.

Paid sick leave provides job and financial security for minority and low-wage workers, whom are most often in jobs that lack sick leave benefits and can least afford to forego a paycheck if they become ill or must care for a family member. In Illinois, roughly 1.6 million workers are in low-wage jobs making $12 or less per hour. While only 14.7% of the Illinois population is African-American and 16.9% of the Illinois population is Latino, 33.6% of African Americans and 44.3% of Latinos in Illinois earn $12/hour or less. These lower income workers are less likely to have access to paid sick days. Nationwide, 80.6% of low-wage workers lack a single day of paid sick leave. And less than half of Latino workers in the US (46 percent) have access to paid sick time compared to 60 percent for all workers.

Working to ensure healthy and productive employees, paid sick leave helps provide a healthy Illinois economy and strengthens the economic security of the state’s citizens.

Written by Militza M. Pagán
Consultant to Voices for Illinois Children


[1] Laws differ on types of employees covered, the number of work hours required to earn paid sick leave, and the maximum number of sick leave hours employees can accrue; a detailed chart of paid sick leave statutes can be at found at http://www.nationalpartnership.org/research-library/work-family/psd/paid-sick-days-statutes.pdf

Proposed Medicaid changes could mean end of services for thousands in Illinois.

Proposed changes to the federal Affordable Care Act (ACA) and Medicaid could result in the reduction or elimination of services for thousands of Illinois residents now covered by Medicaid.

Medicaid provides health coverage to low-income children and their families, pregnant women, persons who are disabled, and seniors.[1] Services covered by Medicaid can include payments for hospital and nursing home care and prescription drugs.[2]

The program, jointly funded by the state and federal government, currently covers 36 percent of Illinois children.[3] In July of 2013, Illinois was one of 23 (now 32) states that opted to expand its Medicaid program under the federal Affordable Care Act (ACA).[4] The ACA expanded eligibility for Medicaid to 138 percent of the poverty line, or, families of three making $26,951.[5]

At the beginning of this year, there were 3.1 million people enrolled in the state’s Medicaid program. Of that amount, approximately 649,000 enrolled under the Affordable Care Act. Illinois now has one-quarter of its population enrolled in the Medicaid program.[6]

While Congress has not yet voted on the proposed legislation, nationally, the Congressional Budget Office has calculated that the proposed changes to the ACA could mean a loss of medical coverage for 14 million people in 2018.[7] The Office estimates that both changes to the tax subsidies that allow citizens to buy coverage and to the Medicaid program could increase the number of uninsured from 14 million to 21 million in 2020, and to 24 million in 2026. It also provides yet another major budget issue for Illinois.[8]

When the ACA became law, the federal government paid 100% of the costs for each new Medicaid enrollee through 2016. The percentage dropped to 95% this year. It is scheduled to phase down to 90% by January 1, 2020. Due to the federal reimbursement for new enrollees, Illinois received more than $3 billion dollars in Fiscal Year 2017.  Overall, Illinois spent approximately $12.5 billion in general funds (and related funds) on Medicaid in Fiscal Year 2016.

The proposed bill would make two major changes to Medicaid starting in 2020, each of which likely would reduce coverage in Illinois unless the state chooses to raise the necessary revenue.

First, it would reduce the federal matching rate for new enrollees in Illinois’ Medicaid expansion from 90 percent to Illinois’ regular Medicaid matching rate, just above 51 percent.[9] That means Illinois would have to pay nearly five times as much as under current law for new enrollees. Moreover, because low-income adults move on and off Medicaid over time, CBO estimates that the higher cost would apply to more than two-thirds of expansion enrollees within just two years. [10]

Second, the bill would cap per-person federal Medicaid funding – not just for the expansion population, but also for children, pregnant women, seniors, and people with disabilities currently covered by Illinois Medicaid.[11] The federal government now matches state Medicaid spending with no dollar limit per enrollee, meaning that federal funding increases based on the actual cost of serving vulnerable populations. Under the House bill, the per-person caps would grow more slowly than projected per-enrollee spending, and so Illinois would face increasing cuts in federal funding over time.

The implications of the federal changes in Illinois would further complicate by the state’s ongoing budget crisis. The state has been operating without a complete budget for 21 months. It has a shortfall of billions of dollars just to meet 2015 service levels and has amassed a backlog of bills totaling more than $12.5 billion[12]. Delayed payments or actual cuts have already led providers to curtail vital human services.

During an Illinois House hearing on the subject, experts testified that the proposed federal Medicaid changes could mean a loss of up to $40 billion for Illinois over a ten-year period. Absent any action by the Illinois General Assembly and the Governor to address the revenue shortfall, vulnerable Illinois residents including low-income children and their families, persons with disabilities and seniors, could see coverage cut and discontinued.

Written by S. Mayumi Grigsby


[1] http://www.cbpp.org/research/health/policy-basics-introduction-to-medicaid

[2] http://www.cbpp.org/research/health/policy-basics-introduction-to-medicaid

[3] http://ccf.georgetown.edu/location/illinois/

[4] https://kaiserfamilyfoundation.files.wordpress.com/2013/07/8457-the-cost-of-not-expanding-medicaid4.pdf

[5] http://www.cbpp.org/research/health/policy-basics-introduction-to-medicaid

[6]https://www.illinois.gov/gov/budget/Documents/Budget%20Book/FY2018%20Budget%20Book/FY2018OperatingBudgetBook.pdf

[7] https://www.cbo.gov/publication/52486

[8] https://www.cbo.gov/publication/52486

[9] http://kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/?currentTimeframe=1&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

[10] http://www.cbpp.org/research/health/house-republican-health-plan-shifts-370-billion-in-medicaid-costs-to-states

[11] http://www.cbpp.org/research/health/house-republican-health-plan-shifts-370-billion-in-medicaid-costs-to-states

[12] As of 3/14/17: https://ledger.illinoiscomptroller.gov/

Cuts Have Consequences: Denying Alzheimer’s Patients Care

Services for people with Alzheimer’s Disease and their families would be devastated by Governor Rauner’s proposed cuts. This affects not just seniors with this terrible disease, but entire families. These cuts are also likely to cost much more than they save, when individuals with Alzheimer’s must go into much more expensive nursing homes sooner.

Governor Rauner suggests that there is no choice — that cutting these services must happen. However, lawmakers do have a choice. They need to raise the revenue our state needs to fund vital services like those that help families dealing with a loved one with Alzheimer’s.

Wandtv.com, NewsCenter17, StormCenter17, Central Illinois News-

Cuts Have Consequences: Denying Services to People with Disabilities

Last week, disability rights advocates protested Governor Rauner’s reckless proposed cuts to services that help people with disabilities live with dignity and independence.

YouTube Preview Image

 

Michael Herzovi told Progress Illinois that “in order to have a life beyond my apartment, I need help.”

Governor Rauner’s budget proposal aims to deny as many as 10,000 people with disabilities in-home services that allow them to live in their own homes, increasing their independence and productivity. These services, funded through the state’s Home Services Program, are critical to having the “compassionate” state that Governor Rauner has called for.

Herzovi described why these services are so important:

Because of this help I’m able to be part of society, to live the life that I decide is best for me; to volunteer; to give back to the community; to work as much as I can; and to pay taxes….The Home Services program helps people live productive, vibrant lives. We need to keep these services funded and growing.

By helping people avoid far more expensive nursing home care, the Home Services Program helps the save money. According to Access Living, each person who receives services through the Home Services Program instead of living in a nursing home saves the state $17,000 a year.

Karen Boyd of Chicago says that, by allowing her to stay at home, these services enable her to raise her 9-year-old daughter.

Gary Arnold of Access Living warns that

these cuts are going to cost money….The way to save money is to invest in the serves and the programs that allow people to live in the community, so they’re not forced to go into institutions, emergency rooms and things like that.

Governor Rauner has also proposed similar cuts to the Department on Aging’s Community Care Program, which provides in-home services to seniors to keep them in their homes and prevent unnecessary nursing home care.

To avoid these damaging cuts, Illinois must raise the resources our state needs to fund critical services that give everyone the opportunity to prosper.

Congress Must Preserve Health Care Coverage for Children

The Children’s Health Insurance Program (CHIP) is a highly successful program that, together with Medicaid, has steadily decreased the proportion of children without health insurance. This progress continued even during the Great Recession, when many families were losing employer-sponsored health insurance.

Unfortunately, the future of CHIP is very uncertain. Congress is currently considering legislation to renew CHIP funding, which is scheduled to expire at the end of September. Failure to extend funding would have harmful consequences for children in Illinois, as well as for the state budget.

The Importance of CHIP in Illinois

As of June 2014, more than 200,000 Illinois children, as well as 12,000 pregnant women, were covered through CHIP. The income eligibility limit for children is currently 318 percent of poverty level (about $64,000 for a family of three), although most CHIP children are below 200 percent of poverty level. Families with incomes above 160 percent of poverty level are responsible for monthly premiums and co-payments on a sliding scale.

CHIP, which was established by Congress in 1997, has played a key role in improving access to health care for Illinois children. The program’s impact has gone beyond the expansion of eligibility for medical assistance. The implementa­tion of CHIP also generated efforts to enroll eligible children through outreach activities and stream­lined application procedures. As a result, CHIP has had important spillover effects by facilitating enrollment of eligible children in Medicaid.

When CHIP was reauthorized in 2009, Congress instituted performance bo­nus payments to states for increasing Medicaid enrollment. From 2009 to 2013, Illinois was awarded more than $50 million in performance bonuses. Illinois was one of only nine states to receive bonus payments for five consecutive years.

The success of CHIP has contributed significantly to the state’s remarkable progress in health care coverage for children. Between 1998 and 2011, the number of low-income children without health insurance in Illinois declined by more than half. In 2013, only six states had lower uninsured rates for all children.

The Imperative of Renewed Federal Funding

The elimination of federal CHIP funding would have a severe impact in Illinois. Some CHIP children would still be covered by Medicaid, but the state would lose about $75 million in funding because the federal match would drop from the enhanced CHIP rate (about 66%) to the regular Medicaid rate (about 51%).

Another important budgetary consideration is that the federal matching rate for CHIP in Illinois is scheduled to increase to more than 88 percent for a four-year period beginning in October 2015. Additional funding for the state would be about $115 million per year.

Among those children who would lose coverage, some would not be eligible for federal subsi­dies through the Health Insurance Marketplace. This is because of the “family glitch” in Affordable Care Act (ACA) — families can­not receive subsidies if they are offered “affordable” employment-based coverage for an individual employee, even if family coverage is not affordable.

Other children who lose CHIP coverage might be eligible for subsidies through the Marketplace — assuming that it isn’t undermined by the U.S. Supreme Court. But these children would likely receive less comprehensive benefits under the ACA benchmark health plans than under CHIP. Moreover, their families would be responsible for larger monthly premiums and co-payments for services. Families who have children with special health care needs would face major financial risk because caps on out-pocket costs will be much higher under benchmark plans than under CHIP.

When CHIP was enacted in 1997, it had broad bipartisan support. The National Governors’ Association has called for the timely extension of CHIP funding. Last year, the American Academy of Pediatrics issued a strong policy statement on the role of CHIP in expanding access to care, improving health outcomes for low-income children, reducing racial-ethnic disparities, and meeting the needs of children with chronic health conditions.

It is imperative that Congress move quickly to extend CHIP funding for at least four years. Illinois has a great deal at stake here. If CHIP funding disappears, the state’s gains in expanding access to health care for children would be in serious jeopardy.

For more information on Medicaid and CHIP in Illinois, see the recent report from the Fiscal Policy Center.