Too much talk, give me some action
By Susy Schultz
It's a basic lesson you teach your children.
Maybe you say it this way: "Actions speak louder than words." Or, "It's not what you say, it's what you do." Or, "Show me, don't tell me."
Usually these are the lines I use after some juvenile atrocity. "Listen young man, if you are truly sorry about crashing into your brother's Lego building, knocking him over onto the dog who slid into the table and broke the flower vase, it is not acceptable to just say, ‘Sorry,' and run off. Get over here, pick up your brother, wipe up the water and rebuild the building."
We want our children to be responsible, to know when they say something they should mean it. We want them to go beyond words and be people of substance.
If we expect our children to know this, should we expect less of our government officials?
Take Kidcare, the health insurance program for children whose parents earn too much to qualify for Medicaid but too little to afford private health insurance.
Gov. Ryan has held a lot of news conferences and used a lot of words to talk about how great Illinois is doing covering uninsured kids, but when I started looking at actions, I found I was searching for substance.
I understand this program a bit since I spent a couple of years in federal government working for a wonderful rabbi in the U.S. Department of Health and Human Services. On the federal level, the program is called the State Children's Health Insurance Program [SCHIP] but locally, each state has its own cute name--KidCare in Illinois.
The federal government pays about 65 percent of the bill, the state pays the other 35. That's better than Medicaid, which splits the cost in half.
When SCHIP started in 1997, there was $40 billion over 10 years in federal money. The federal government tried to get this money to states by making the applications as simple as possible--OK, simple and federal government are oxymorons--but as simple as it gets. And just like Medicaid, the federal government set up guidelines but the states were left to design the program and who will be covered.
Great if someone has the right priorities.
"Increasing KidCare enrollments continues to be one of my top priorities," he said in September. "Our hard work has made Illinois a national leader in providing health care coverage to kids."
Illinois, a national leader. Great news, great words. But back to actions.
"When I took office, the state had enrolled about 28,000 kids and pregnant women into the program. By simplifying the enrollment process and aggressively spreading the word about the program, we have enrolled more than 166,000 kids and pregnant mothers into KidCare--a six-fold increase since January 1999," Ryan said.
So, far so good. Studies show children are more likely to get timely health care if their parents do. So, the federal program allows states to roll in parents if the right paperwork is filed. Our governor said it was the right thing to do and Illinois filed papers to start Family Care.
"By expanding the program to include parents, we expect to improve the health of families and encourage the enrollment of additional children with their parents," Ryan said. Illinois' program covers children up to a certain income--such as $28,888 for a family of three. But 40 states have programs with cutoffs that cover families at a much higher level--$30,040 for a family of three. No leading there.
For every $1 the state pays, the feds pay $2 and some child gets $3 worth of health care. What other state program can claim such a big return on taxpayer investment? In the six years since this program started, Illinois could have received more than $800 million in federal health care dollars. But, because the state was not willing to appropriate its share, we have foregone $534 million--leaving way too many kids without coverage.
"Illinois is towards the bottom in SCHIP expenditures," says Melanie Nathanson, the Center on Budget and Policy Priorities' senior policy analyst.
OK, it isn't easy for the state to pay it all and wait for the fed to refund its 65 percent share. It's even harder when the state is facing a $2 billion shortfall. But the program got off the ground in 1998, the same time the state began receiving $668 million from its share of the tobacco settlement money. Other states used that money to pay their share of children's health care, Illinois did not.
Are we leading yet?
Then, there is Family Care. This program, which started in October, serves families earning up to 49 percent of the poverty level--just $7,459 for a family of three. To qualify for SeniorCare, another low income health insurance program serving the elderly, one person can earn up to $17,720 a year. At least 20 other states for several years have had an income cutoff twice as high as Illinois.
Illinois is a leader? The more I discovered, the more I found when it comes it KidCare, we're leading in words. Still, what can you say? Ryan leaves the governor's office this month as Rod Blagojevich comes in. Chances are Ryan will talk about KidCare as one of his accomplishments. But I am hoping Blagojevich will do more than talk.