HR1346 96TH GENERAL ASSEMBLY

HR1346 LRB096 22645 KTG 41977 r

HOUSE RESOLUTION

WHEREAS, The Illinois Covering ALL KIDS Health Insurance Program was created by the General Assembly and the Governor in 2005 with the intent to make Illinois the first state in the nation to provide affordable, comprehensive health insurance for every child in the State; and

WHEREAS, At the time the Covering ALL KIDS Program was established, it was estimated based on adjusted 2003 Census data that 253,000 children in Illinois were without health insurance, more than half of whom came from working and middle class families who earned too much to qualify for other State health care assistance programs, but did not have enough money to afford private health insurance; in the years since, due to the effects of a national recession and economic slowdown worse than any experienced since the Great Depression era, the need to provide access to health care to children whose families lost jobs, income, and insurance formerly provided by a parent's employer, has become even greater; and

WHEREAS, Research shows that uninsured children suffer because they do not have access to adequate medical care; this factor puts uninsured children at higher risk for hospitalization or missed diagnoses of serious conditions; children without health insurance often delay treatment, which can result in more complex, specialized, expensive, and emergency care for critical conditions; and

WHEREAS, Studies have demonstrated that children with health coverage are more likely to get preventative care, stay healthy, have higher rates of school attendance, and perform better academically; and

WHEREAS, While the uninsured pay approximately 35% of their medical bills out of pocket, more than 40% ends up being absorbed by those who do have health insurance in the form of higher premiums; and

WHEREAS, The Covering ALL KIDS Program is intended to make available to children comprehensive health insurance to cover doctors' visits, hospital stays, prescription drugs, vision care, dental care, and medical devices; parents are required to make monthly premiums and co-payments for doctors' visits and prescription drugs at affordable rates determined by their family's income; and

WHEREAS, The Illinois Hospital Association, the Illinois Academy of Family Physicians, and the Illinois State Medical Society supported the creation of the Covering ALL KIDS Program; businesses, labor organizations, community service agencies, non-profit organizations, clergy, and elected officials from across the State gave the Program their endorsement; and

WHEREAS, Legislation to establish the Covering ALL KIDS Program, House Bill 806 of the 94th General Assembly, passed the House and the Senate with bipartisan majorities in October 2005; the bill was signed into law in November 2005 and became effective July 1, 2006; and

WHEREAS, The clear intention of the lawmakers who supported the creation of the Covering ALL KIDS Program was that it would be run in a competent, professional, and responsible manner; that State health care agency officials and employees would use the authority granted to them by statute to administer the Program properly and to ensure that enrollees and their families were correctly screened for State residency and income verification and required to pay the appropriate premiums for their income level; and that proper documentation and records for Program participants would be maintained; and

WHEREAS, In September 2008, lawmakers approved via unanimous, bipartisan votes House Bill 1533 of the 95th General Assembly, which became effective June 1, 2009 and required the Illinois Auditor General to conduct annual audits of the Covering ALL KIDS Program, including payments for health services covered by the Program and contracts entered into by the Department of Healthcare and Family Services; and

WHEREAS, On May 11, 2010, the Auditor General released a report entitled "Program Audit of Covering ALL KIDS Health Insurance Program"; among the audit's findings were that the Department of Healthcare and Family Services incorrectly categorized some documented immigrants as undocumented immigrants, the number of undocumented immigrants, as well as the costs associated with them, are overstated in data provided by the Department, and the number of documented immigrants, as well as the costs associated with them, are also understated; the Auditor General noted that by not correctly classifying documented immigrants, not only is the Department reporting incorrect data, it is also losing out on federal matching funds it could be receiving for documented immigrants; and

WHEREAS, The Auditor General also found that the Department of Healthcare and Family Services and the Department of Human Services were not obtaining documentation to support eligibility in some instances; in particular, procedures for verifying residency and income had not been utilized in many of the case files reviewed by the Auditor General; as a result, the Auditor General could not determine whether eligibility was determined correctly by the Departments; this could result in a family paying a higher premium or co-pay, or could result in the State paying for a greater portion of a child's medical services than necessary; and

WHEREAS, The Auditor General reported that the Department of Healthcare and Family Services had difficulty producing complete and accurate sets of data in a timely fashion for the audit; that the Department of Healthcare and Family Services and the Department of Human Services did not have adequate controls in place to ensure that individuals over the age of 18 were terminated from Covering ALL KIDS eligibility as required by State law; that the Departments did not have adequate controls in place to ensure that individuals were not enrolled in the Covering ALL KIDS Program more than once with the likely consequence that duplicate enrollees would overstate the number of children served by the Program as well as indicate a weakness in internal controls associated with enrolling the children; and

WHEREAS, The Auditor General's report contained 13 recommendations; 8 recommendations were specifically for the Department of Healthcare and Family Services and 5 recommendations were for both the Department of Healthcare and Family Services and the Department of Human Services; both Departments generally agreed or partially agreed with all 13 recommendations; and

WHEREAS, It is vitally important that the people of Illinois have faith that the Covering ALL KIDS Program is being administered according to the requirements of the law and in the best interests of the taxpayers of Illinois; that participants are screened correctly for residency, eligibility, and income levels; that enrollees pay the proper amounts for the care they receive; and that proper records are maintained; therefore, be it

RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE NINETY-SIXTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we request that the Director of the Department of Healthcare and Family Services, the Secretary of the Department of Human Services, the Chief Operating Officer of the State, and the Deputy Governor with responsibility for the Covering ALL KIDS Health Insurance Program, be prepared to testify before the House State Government Administration Committee during the General Assembly's 2010 fall Veto Session about the steps they have taken to rectify the problems uncovered by the Auditor General's audit of the Covering ALL KIDS Program; that we urge the Governor to take appropriate action to hold those who have failed to operate the Covering ALL KIDS Program properly or misled the public, press, lawmakers, or auditors accountable for their actions via discipline, reprimand, or termination; and be it further

RESOLVED, That copies of this resolution be delivered to the Governor, the Chief Operating Officer for the State of Illinois, the Director of the Department of Healthcare and Family Services, and the Secretary of the Department of Human Services.