Illinois Insurance Brokers Seek Solutions for the Uninsured

Published August 1, 2004

On May 26, the Illinois General Assembly passed the Health Care Justice Act (House Bill 2268). The bill sets as a policy goal the creation of a state health care plan covering a full range of preventive, acute, and long-term care services. Gov. Rod Blagojevich (D) is reported to be likely to sign the bill.

The bill is particularly aimed at addressing the problem of the uninsured, but questions have arisen over whether such a dramatic change as proposed in the bill is necessary to solve the problem.

The act’s preamble states that Illinois has 1.8 million uninsured and uses that figure to justify a move toward universal care. The California-based Foundation for Health Coverage Education (FHCE)–which has studied the uninsured nationally–estimates the true number of uninsured in Illinois is about 371,000. The rest qualify for existing government programs, go without coverage even though their incomes indicate they could afford health insurance, or are only short-term uninsured.

Insurance Brokers Organize

More than a year ago, approximately 75 Illinois insurance brokers, consultants, and employee benefit providers responded to the lack of communication between elected officials, experts, and health care consumers by creating the Statewide Employee Benefit Broker-Consultant-Provider Coalition (SEBBC) to address health care access and the uninsured.

Coalition founder John Garven, president of Benico Ltd., an insurance and employee benefits consulting firm in Huntley, in far northwest suburban Chicago, told Health Care News, “We intend to develop strategies for informing and educating the public and legislators on these very important issues.

“We want to get small businesspeople and our colleagues to tackle the uninsured and health care access issues. … Let’s understand the options that currently exist and get people the assistance they need,” Garven said.

Garven said Illinois already has many good public and private assistance programs available to help the state’s uninsured residents. Unfortunately, many who qualify do not know about the programs.

“We need to inventory what’s out there,” Garven said. “Before we come up with global solutions, let’s get people understanding what’s already available to them and signed up. If there are still gaps, address them through other types of legislation.”

California Model

Garven’s group hopes to emulate the work of the FHCE, which has helped steer uninsured persons in California to existing programs while educating consumers and legislators on the known failures of single-payer health care plans in the United States and abroad. Garven and some 35 other SEBBC members participated in a May 24 conference call with officials at FHCE, to seek advice on how to work in Illinois.

The FHCE came into being nearly 10 years ago, in response to moves to create a single-payer system in California, said Phil Lebherz, FHCE’s executive director and founder. The group compiled information on the uninsured and the many public and private programs that already provide California residents access to health care. They also created a Web site––that features a complete overview of the options available for people in almost every demographic profile, as well as a reference list of phone numbers and Web sites.

Garven said he and his coalition partners plan to create a similar Web site for Illinois.

“I figured I should create this matrix and show it’s not true that people can’t get health care,” Lebherz said. “I started gathering information and responding to every reporter who said ‘Mary Jones’ could not get coverage. I would show them how she could. They’d never respond.”

Lebherz said approximately 3 million of California’s estimated 6.7 million uninsured persons qualify for existing government health programs, and more than 2 million others have incomes above $50,000 but choose to go without coverage.

How Many Uninsured?

Nationally, FHCE estimates there are approximately 9 million uninsured, not the more than 40 million figure that is widely cited. About 14 million uninsured persons qualify for government health programs, and another 18 million decline insurance yet have incomes in excess of 200 percent of the poverty level, choosing to pay medical bills out of their own pockets.

Those estimates are based on studies by various agencies, including the Congressional Budget Office, National Institute for Health Care Management, and U.S. Census Bureau.

“These 9 million people are just above qualifying for programs [because of their income levels], but they don’t have enough money to buy insurance,” Lebherz said. “Why change the whole system? Why not just help those 9 million?”

Garven said the SEBBC hopes to promote such proposals in Illinois. He said California lawmakers now see insurance brokers and agents as rather like consumer advocates, because of the efforts they have made to help people understand and obtain insurance through existing programs.

“They’re seen as representing more than the insurance industry,” Garven said. “We might need to be concerned about positioning ourselves more as consumer advocates, to define the role of the agent. We are often confused as being one and the same with the companies, so I believe we need to bring more visibility and understanding to what it is that we do for these lawmakers’ constituents and the value we provide.”

Steve Stanek is an Illinois-based freelance writer and regular contributor to Health Care News. His email address is [email protected].