We’ve been beating the drum for comprehensive health care reform for the better part of a year now. Some new figures out last week show that even though national policy appears to be moving in the right direction, piecemeal reforms at the state level continue to fall short.

Take Illinois, for example. Despite having All Kids, one of the most progressive, state-backed children’s health insurance programs in the nation, some 300,000 children still lack coverage.

Why? Kathy Chan of the Maternal and Child Health Coalition cites the tumultuous job market as a major factor. She explained to us that signing up low-income kids—who families consistently lack health care coverage—is far easier than reaching out to working-class families with slightly higher incomes, who are in growing need of insurance for their children because of employment instability. “Uninsured families, especially those working one or two jobs, keep coming on and off insurance,” Chan said. “That continues to drive the numbers up.”

Rolling the All Kids application into the unemployment benefits process could make a difference. And there’s plenty of potential for making the application itself less cumbersome. (Chan notes that the odds of filling it out correctly the first time more than double if a trained outreach worker walks an applicant through the process.) Yet as far as we know, there’s no legislation out there to accomplish either of those objectives.

Of course, such fixes would be no substitute for the automatic enrollment that comes with a single payer system.

Another obstacle to effectively increasing All Kids’ enrollment is the ongoing fiscal crisis in Illinois.

Even before the backlog of bills topped $4 billion, the Department of Healthcare and Family Services, which oversees All Kids, was consistently behind on its reimbursements to health care providers who treat government-insured patients. Things have only gotten worse in the past year.

“First we need to address that some providers haven’t been paid in months or even years,” Citizen Action health care lobbyist Patrick Keenan-Devlin told us. Gaining support for bills like HB 5331, which would raise the reimbursement rate for the first time in more than a decade, could also go a long way in bolstering support among providers.

The ongoing financial mismanagement in Illinois is not only troublesome, “it’s hurting kids,” Keenan-Devlin said.

All Kids should be a national example for how government-backed health care can relieve the burden on working families. But when Illinois is among the six states (PDF) with the largest number of uninsured children, that’s a hard case to make.