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On a pleasant Saturday morning, James
“Rock” Haley would rather be building a deck or demolishing a
vacant home, something he says he learned to do as a teenager using little
more than his bare hands. With broad, sturdy shoulders and muscular forearms,
Haley looks every bit deserving of the nickname that’s he had since
childhood, not someone who just celebrated his 70th birthday. Now that the weather’s warming up, Haley wants
to buy a beat-up old pickup truck so that he can take on more landscaping
jobs or hire a small crew to help him knock down a few houses to earn some
extra cash. Even though he’s retired, Rock can’t
afford
to rest. His wife, Edna, has a rare muscle disease known as
polymyositis, and doctors have said that her condition prevents her from
working. During an hour-long interview at their home, the 53-year-old woman
quickly grows restless, wincing from what she describes as an unusually
high level of pain. Edna Haley doesn’t have health insurance, which
means that the couple must pay for her medicine — she takes nine
pills every day at a cost of $300 per month — out of pocket. The problem is that after paying for rent, utilities,
and other household expenses, there isn’t much left of Rock
Haley’s monthly $725 Social Security check — and anything
invested in a business would mean less money for Edna’s health care. The couple may soon get some relief in the form of a
massive new health plan rolled out last week by Gov. Rod Blagojevich.
Coming on the heels of All Kids and Preschool for All proposals, put in
place last year, Illinois Covered would extend access to health care for
millions of uninsured adults in the state. About 500,000 Illinoisans who lack health insurance
could be covered. To finance the plan, the governor has proposed a
gross-receipts tax on businesses earning revenues of more than $1 million,
which he labels a “tax-fairness plan,” as well as a payroll tax
of 3 percent on companies that don’t offer medical insurance. Business groups and Republican lawmakers fired their
first salvos before the governor started his annual budget address last
week by pointing out that the proposal, which would raise $6.1 billion a
year, would be the largest tax increase in the state’s history. Meanwhile, health-care advocacy groups lauded the
governor for taking steps to fix a broken health system. Rock Haley just want to be able to get his wife, who
is also diabetic, the prednisone and other drugs she needs to soothe
inflammation in her muscles and test strips with which to monitor her
blood-sugar level. The day before Thanksgiving, Edna’s blood sugar
plummeted, and she had to be rushed to the hospital for the third time in
18 months. Even though he doesn’t have a car, the ambulance crew
wouldn’t let Rock ride with his wife to the hospital. “I’ve been fighting this for a year and a
half — and I know I’m not the only person,” he says.
“I’m sure there are other people with spouses who are sick
going through the same thing.”
Each of the four times the Haleys have tried to get
help from the federal government by applying for Supplemental Security
Income, they say, Edna has been denied. When they turned to the Illinois Department of Human
Services for state assistance, the agency sent them a letter stating that
“based on information provided you are not eligible for any programs
the department offers.”
With $8,700 per year in income and no other assets,
they can’t understand why Edna wouldn’t qualify for any
government programs. Local charities have been able to help out some. The
Haleys also contacted the offices of U.S. Sen. Dick Durbin, D-Ill., and
state Sen. Larry Bomke, R-50th. Edna was twice issued a temporary medical card, good
for 60 days. But the specialist whom Edna needs to see is typically booked
months in advance, and she can’t get a prescription without seeing
the doctor. But, as Rock Haley says, they’re not alone.
About 1.7 million people in Illinois go without medical coverage, according
to the Kaiser Family Foundation. Nationwide, the number of uninsured is
46.5 million. With Illinois Covered, the governor is trying to
remedy the problem for the Haleys and people like them. On Sunday, March 4, speaking at the Fourth
Presbyterian Church, in downtown Chicago, Blagojevich took the wraps off
his plan for universal health care in Illinois. To make his case, the governor cited studies showing
that lack of insurance reduces workplace productivity, causes families to
go bankrupt, and is a leading cause of death in our nation.
He spoke of the effect of spiraling health-care costs
on small businesses and noted that other large states, such as California,
Massachusetts, Pennsylvania, and have already taken steps to provide health
care for all. Maine, Maryland, Massachusetts, Hawaii, Vermont, and
Tennessee also have adopted universal healthcare programs, while Oregon,
New Mexico, and Arizona, are currently considering the idea. Under Illinois Covered, any adult who doesn’t
have employer-sponsored medical insurance would qualify for comprehensive
coverage, which includes prescriptions, regardless of health status. As explained on the state’s Web site, the
Blagojevich plan consists of three tiers: Illinois Covered Choice, Illinois
Covered Rebate, and Illinois Covered Assist. Under Covered Choice, small businesses with fewer
than 25 workers that agree to pay 70 percent of the premium would be able to buy group
coverage for less than they could now on the open market. Families of four
earning $45,000 annually could get coverage for $2,250.
Under Covered Rebate, premiums would be capped
on the basis of family income, and for workers who receive insurance
through their jobs the state would work with the insurance company to cover
the difference between the state-offered discounted premium and the amount
the insurance company actually charges. Finally, Covered Assist aims to help people such as
the Haleys who live below the federal poverty level — $13,690 in
annual income for a family of two — and who either don’t have
access to employer-funded insurance or don’t qualify for Medicaid. In
this instance, the state would pick up the tab for their health care. Blagojevich’s proposal won’t be an easy
sell, however. Critics point out that the state already has a
backlog of $2 billion in unpaid Medicaid bills. In addition, Illinois is already at the bottom among
states in meeting its pension obligations — $38.6 billion in total
unfunded liabilities. His health-care plan aside, the governor is also
proposing $10 billion more for Illinois schools. Leasing the state lottery
system should help pay for pensions, Blagojevich says. However, he wants
corporations to help pay for the bulk of his new initiatives. During his budget address, the governor said while
middle-class families have shouldered more and more of the state’s
tax burden, the wealthiest corporations walk. A gross-receipts tax, which the governor says has
worked successfully in other states, at a rate of 1.8 percent on service
industries would close loopholes that preclude some corporations from
paying corporate income tax. Other industries — construction,
manufacturing, retail, and wholesale companies — will be taxed at 0.5
percent.
Exports, food, and medicines would be exempt from the
tax.
Bomke, the state senator, says that even though he
considers the governor’s proposal “pretty close” to
socialized medicine and thinks that funding Illinois Covered might be
difficult, given the state’s horrible fiscal shape, he’s not
opposed to the idea in principle. “We have an obligation to provide insurance for
people who otherwise can’t get it,” he says, “so
I’m certainly in favor of trying to find some mechanism to help those
people, like Edna.”
State Rep. Raymond Poe, too, feels that
“expanding health-care coverage is a worthy goal we should strive
toward” — but the Springfield Republican says he can’t
vote for its funding mechanism in the current form. “Being fairly conservative, I’m always
concerned about how we pay for things,” Poe says. “The health
part, people are pretty receptive to. They like that it’s going
through the insurance companies.”
However, he calls the gross-receipts tax a covert tax
increase on working families. “People understand that it will cost the
consumer in the end when they buy coffee, or a car, or a new
refrigerator,” he says. When asked whether he believes that a lack of
health-care coverage is also a hidden tax on poor people, some of whom are
Poe’s constituents, he replies: “Absolutely.”
Dick Kay, the governor’s special advocate for
health care, says that Illinois Covered was designed with people such as
Edna Haley in mind.
A former Chicago TV newsman, Kay signed on to help
Blagojevich sell his idea because Kay’s son, a freelance artist, has
struggled to find health insurance. He describes the plan as a version of the Medicaid
program — just one that lacks reimbursement from the federal
government. His son would qualify, and without knowing all the
specifics of her situation, Kay says, so would Edna Haley. Critics such as Bomke worry that a program that
forces insurance companies to take on people they would otherwise not
cover, even if taxpayers are helping pay for that additional cost, could
push premiums up for everyone. Bomke says he wants to avoid putting Illinois into a
situation similar to the one it was in the several years ago when a number
of doctors left Illinois in the face of the rising cost of
medical-malpractice insurance. This led to legislation, passed in 2005,
capping the amount in non-economic damages that Illinois juries can award
in malpractice cases. Kay doesn’t agree with the parallel: “The
insurance companies will get more business, frankly. If the state is
willing to assist with the premiums, more people are going to get
coverage.”
Health insurers companies don’t want high-risk
patients but have record profits, Kay says. “The insurance companies cherry-pick, and they
would prefer to have persons who are covered by their employers. They
don’t want people with risk; they don’t want the people with
prior conditions —but I think like the governor thinks: It’s a
moral imperative; the state has a responsibility to help people like that. “Yeah, the insurance companies might not like
the plan to cover everyone, regardless of their health risk, but they will
be paid for.”
Responding to the governor’s budget address,
Illinois State Chamber of Commerce president Doug Whitley called the
Blagojevich proposals reckless and irresponsible. If approved, businesses will be forced to slow
expansion, trim jobs, or flee to more business-friendly states, Whitely
says. He also takes issue with the governor’s assertion than
businesses aren’t paying their fair share of taxes. Over the last four years, corporate income-tax
revenues have grown by 87 percent and overall business taxes have gone up
34 percent, the chamber asserts.
“Businesses are paying their fair share,”
Whitley says. “Focusing on corporate income-tax receipts to assess
the tax burden borne by business is misleading.”
Surprisingly, many health-care providers, who
continually bemoan the state’s slow Medicaid-reimbursement cycle, are
on board with the proposal. The Illinois Hospital Association, Illinois Primary
Health Care Association, and Illinois Academy of Family Physicians have
joined with dozens of health advocacy groups and nonprofit associations to
form the Illinois Health Care Justice Campaign in supporting Illinois
Covered.
IAFP executive vice president Vince Keenan says that
members of his organization are encouraged by Illinois Covered’s
focus on preventative care and providing individuals with a
“health-care home” as opposed to the current structure, which
serves mainly as system for paying bills.
It’s a large but incremental step, Keenan says.
“Family physicians, in general, are scientists
— so we’d like to have more details, but we’re excited
about what we hear. We’re also businesspeople, so the funding
mechanism has received a lot of attention, but that’s really not our
bailiwick.”
The day before
Blagojevich gave his speech, Maryam Moustoufi was at the Capitol,
representing the Islamic community pushing for health-care reform from a
faith-based perspective.
“All of the great world religions believe in
justice for all individuals, and health care is a justice issue,” she
says. “Within Islam there’s a saying that says we should not
sit down to dinner until we have checked to see if our neighbor has food to
eat.”
Moustoufi’s husband has leukemia and must take
medication that costs $100 per pill, but he has health insurance through
his employer, the state of Illinois. Otherwise, it would be hard to find $3,000 every
month for the rest of their lives, she says. “People talk about the United States’
moving towards a two-class system, but quite frankly I think we’re
already there, because people’s lives are being determined by whether
they have health-care insurance,” Moustoufi says. Whether the governor can actually get his budget
package passed remains unclear. Although he has the support of Senate
President Emil Jones, many lawmakers, including Democrats, listening to
Blagojevich’s budget address didn’t seem thrilled when they
heard about the tax increase. In the meantime, people such as Edna Haley will just
have to wait it out. Her weight is down to 120 pounds from 167 last year.
Some days she’s too weak to even hold a glass of water. Rock Haley isn’t sure whether it’s the
federal or state government at fault; he just knows that the system
doesn’t make any sense. With an appeal pending, the couple hopes that DHS
will overturn its decision. “You can only do so much with
$725,” Rock says. “She’s not going to get any better. When
she doesn’t have her medication, she just has to sit here and suffer.
The hardest part has been watching her deteriorate.”
Contact R.L. Nave at rnave@illinoistimes.com.
This article appears in Mar 8-14, 2007.
