Illinois Health Matters, September 11, 2008

"SARAH"-All Kids Bridge can help save the lives of young adults

A Chicago physician told the Shriver Center about "Sarah," whose name we have changed.

Seventeen year-old Sarah has lupus and currently receives health care thanks to All Kids, the comprehensive health insurance program available to all Illinois children. When Sarah turns 19, she will age out of All Kids coverage and may face a life-threatening disease without health insurance to help pay for necessary care.  Lupus causes inflammation in many major organs and, without proper care, is fatal. When Sarah is too old for All Kids, Sarah's family probably will not be able to pay for all of Sarah's health care costs or for an individual policy with a private insurance company. Even if they could, it's unlikely that an insurance company would cover her because of her preexisting condition. This is why All Kids has literally been life saving for Sarah. This is also why Illinois needs to create a health program for children with chronic illnesses who reach adulthood.  Such a program, All Kids Bridge, is under discussion at the Illinois Comprehensive Health Insurance Program (ICHIP) board.  ICHIP provides health coverage with affordable premiums to Illinois residents unable to obtain it from private insurers due to their pre-existing conditions. The changes under discussion would make ICHIP premiums more affordable for young people too old for All Kids. Illinois must adopt the All Kids Bridge program so that Illinois children don't dread turning 19 because they will lose life-saving health care simply by having a birthday.

"NORMA"- high-deductible policy close to useless 

A Chicago physician told the Shriver Center about "Norma," whose name we have changed.

Norma, a self-employed yoga instructor, lives in Chicago and is a few years shy of 65, when she will be eligible for Medicare.. Until then, she must rely on an individual health policy with a private insurance company that carries a $5,000 deductible. When Norma began to experience chest pain, she visited a primary care physician who suggested a stress test to diagnose the pain. Norma was reluctant because she wanted a bone density test (for osteoporosis) and a mammogram (for breast cancer) and hoped to spend what money she had for those tests.  Both tests are medically necessary for women of her age. Eventually, after some persuasion by her doctor, Norma authorized the stress test, and she was diagnosed with high blood pressure and treated accordingly. Unfortunately, because of the $5,000 deductible, Norma paid for the chest pain diagnostic test and treatment entirely out-of-pocket. As a result, she could not afford the preventative mammogram and osteoporosis screens. For Norma, having insurance is almost useless.  She's spending her money on insurance premiums and then delaying recommended health care procedures because she cannot afford to pay their uncovered costs.  To help people like Norma and the millions of others in the same boat, Illinois should do whatever needs to be done to guarantee that everyone has affordable, comprehensive health care choices.

Illinois Health Matters is a Sargent Shriver National Center on Poverty Law newsletter that describes health care in Illinois through the stories of state residents. Our intent is to show the reality of health care in Illinois. Our hope is that this reality will help Illinois celebrate, use, and safeguard what is already good and drive Illinois toward constant improvement and health care for all.

We want your stories for Illinois Health Matters! We are extremely careful about your confidentiality and will always clear any of your information with you first before we use it. If you would like to share your story (or the story of someone you know) please contact us and we will follow up with you:

Callie Dendrinos
calliedendrinos@povertylaw.org
Direct line: 312.368.1168

P.S.    Callie Dendrinos joined the Shriver Center as the 2008-2009 Americorps VISTA working on health policy in August.  She replaced departing VISTA Melissa Cubria who is now in Austin, TX, doing health policy advocacy work.