Progress Illinois

On the heels off our recent health care coverage comes a new report, courtesy of the Gilead Outreach and Referral Center, with more bad news: the number of uninsured in Illinois has grown for the third straight year. Up 2.1 percent from 2005, 1.75 million Illinoisans went without insurance in 2006, the latest available data. The Tribune's medical blog Triage has more details. Here are a few key findings:

- 44 percent of the uninsured (764,237 Illinoisans) work full time, and another 14 percent (246,358) work part time.

- 30.9 percent of Hispanics (495,202) are uninsured, compared with 23 percent (399.012) of African-Americans and 10 percent of Caucasians (747,677).

- A surprising number of children in Illinois are uninsured, despite the state’s All Kids program. The census data puts the number at 323,197 children 18 or younger.

(Hat tip: Division Street)

Every year, fewer people have health insurance, and those that do are paying more and more to hold on to it. That's as true in Illinois as it is in the rest of the country according to a report (PDF) out today by the Robert Wood Johnson Foundation. The Foundation commissioned an analysis of U.S. coverage to better understand "the cost of family health insurance premiums as compared to income." The study reveals not only the skyrocketing cost of coverage, but also the number of those who have been left behind completely. Before we take a look at the Prairie State, here are some of the findings on the national scale:

Nationally, the average cost of family coverage increased nearly $2,500—from $8,281 in 2001 to $10,728 in 2005. The percentage of family premiums that employees pay held steady at about 24 percent. The amount that workers pay for family premiums, on average, increased $664, from $1,921 in 2001 to $2,585 in 2005. Meanwhile, the median income of people who hold family health insurance policies increased just $1,250 during the same period, from $40,818 in 2001 to $42,068 in 2005.

The news is not any better in Illinois. Not only is the cost of coverage up, but fewer and fewer jobs are offering insurance at all. The report shows that 26,627 less employers offered private health insurance in 2005 than in 2001. That amounts to 660,000 jobs that lost medical benefits during that five year span.

(More after the jump ...)

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Even if the nation is not yet officially in "recession," many states -- Illinois among them -- might as well be. Today the National Council of State Legislatures (NCSL) released a survey of legislative fiscal directors indicating that numerous state economies are currently in crisis. The economic trouble is being felt especially in state budgets, as money brought in through taxes is not keeping up with spending:

Because most FY 2008 budgets were built on revenue forecasts that are not materializing as expected, budget gaps have grown. In November, seven states and Puerto Rico reported shortfalls. That number rose to 16 states and Puerto Rico by mid April. Collectively, these gaps totaled at least $11.7 billion. The situation is worse for FY 2009: Budget gaps have emerged in 23 states and Puerto Rico, and collectively they exceed $26 billion. Again, slowing or declining revenue is the principal reason. In fact, two-thirds of the states are concerned about FY 2009 revenue performance. Four states are pessimistic.

Illinois is listed among the 34 states "concerned" with the 2009 budget gap, but it is also one of only four states that refused to estimate how big that shortfall might become. Instead the Illinois respondent wrote that:

The revenue picture for FY 2009 is far from clear. It appears that limited base growth is the best officials can hope for. Unfortunately, appetites for expanded health care, education, capital needs, and other worthy programs continue to build. Add to that the continued pension funding pressure and bills incurred but unable to be paid, and the resulting budgetary difficulties continue to build.

The "bills" in question include over $700 million the state owes in new pension payments, as well as millions of other expenses for Fiscal Year 2008 that the state will have to figure out how to pay for if it does not want to run a serious deficit. Speaking earlier this year about the 2008 budget, State Comptroller Dan Hynes has already noted that:

Fiscal spending pressures include more than $700 million in new pension payments for state workers and $500 million in rising Medicaid costs. Add in $400 million for education -- a typical annual boost for schools - - and the overall new costs for those three major spending areas alone could hit $1.6 billion in the new budget, Hynes said. That would be twice as much as what the governor expects this year in revenue growth.

According to the NCSL, states are facing their respective budget crises in different ways. Eight of them are considering an income tax hike, while others are looking at deep budget cuts and dipping into states "rainy day funds" to weather the storm.

Illinois did not list any of these options in its response, despite several proposals to revamp the state's regressive flat income tax. Instead, the state pointed to "closing loopholes in the corporate income tax, changing riverboat taxes, and selling the lottery and other state assets" as possible solutions.

A human rights organization released a report today which found that "poverty increased in 74 of Illinois' 102 counties" between 2000 and 2006 and now "afflicts more than 1.5 million Illinoisans," a 19 percent increase during this period. The news is particularly bad for residents of the Chicago suburbs. According to the Heartland Alliance study, the median income of residents in the collar counties has steadily declined:

Between 2000 and 2006, median annual household income declined by $4,877 in Cook County; $8,470 in DuPage; $8,077 in Kane; $5,871 in Lake; $6,498 in McHenry; and $2,495 in Will. During the same period, prices of vital household necessities escalated exponentially: food costs increased by 15.4 percent, medical care by 31.2 percent, energy by 60 percent and gasoline by 92.7 percent. This trend is likely to continue: One-third of all jobs in Northeastern Illinois, (the Chicago region as well as Grundy, Kendall, and Kankakee Counties) are low-wage service jobs.

The findings also highlight the plight of the working poor. According to the study, 210,000 people who have a job in the area still live below the poverty line. Adding to their burden is Illinois' regressive income tax system:

When both state and local taxes are taken into account, Illinois’ poor families have an effective tax rate of 13.7 percent – nearly triple the share (5.1 percent) assessed on the top 1 percent of households in the state.

But as the map below shows, the problems are not isolated to the Chicago area. Amy Rynell, Director of the Mid-American Institute on Poverty for the Alliance, says they require statewide solutions, starting with the Illinois tax code.

(More after the jump ...)

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A new report by the Pew Research Center corroborates what many folks in the U.S. have been feeling for years: the middle class is getting squeezed. Here are a few key insights:

- Americans feel stuck in their tracks. A majority of survey respondents say that in the past five years, they either haven't moved forward in life (25%) or have fallen backwards (31%). This is the most downbeat short-term assessment of personal progress in nearly half a century of polling by the Pew Research Center and the Gallup organization.

- From 1983 to 2004, the median net worth of upper-income families more than doubled, while the median net worth of middle-income families grew by just 29%. In effect, those in the middle have been making progress in absolute terms while falling behind in relative terms.

- As expenses have risen, middle-income Americans have taken on more debt, often borrowing against homes that, at least until recently, had been rising rapidly in value. The median debt-to-income ratio for middle-income adults increased from 0.45 in 1983 to 1.19 in 2004. Ratios have also increased for upper- and lower-income adults, but not by as much.

These findings -- combined with a recent New York Times poll in which 81 percent of respondents thought “things have pretty seriously gotten off on the wrong track” -- suggest historic levels of public pessimism about the nation's direction. After eight years of President George W. Bush, whom historians are already identifying as the nation's worst president, it's really no surprise.

Democrats should jump all over these trends, making the case that increased financial regulation, progressive taxation, and smart government spending can decrease the sickening inequality and slow growth of the bottom 99 percent of Americans. As we've noted before, Barack Obama's indictment of the political culture that led to the mortgage crisis is a good example of how to tie together the squeeze's disparate causes.

But messaging on this issue can be a little challenging, too.

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The Families USA report isn't the only discouraging news on the health care front here in Illinois. A study recently released by the Agency for Healthcare Research & Quality (part of the Federal Health and Human Services Department) analyzed over 100 separate metrics and concluded that the quality of health care in Illinois is getting worse. As the illustrations here show, on 10 of the 12 major "indicators," the state's performance decreased between 2005 and 2006.

On Chicago Public Radio's Eight Forty-Eight this morning, Dr. Quentin Young discussed some possible reasons for this slip. Among the causes he cited were the dwindling number of primary care doctors in the state, and of course, the growing lack of health insurance:

YOUNG: Geography is important. There are a lot of people in this state outside of Cook County, but they're spread very thin. And downstate facilities have constantly gone down. For example, obstetrical care is frequently 30 or 60 miles away. Some of the arguments are that the malpractice costs have made that happen. It's possible, because an OB-GYN can be charged $100,000 to $150,000 just to open his door. There's more to malpractice issues than that, but it's out there.

Another one, I think, is the shift toward specialism. This state, like many, has a hypertrophied specialized group -- meaning, these are people who do things -- surgeons, gastroenterologists -- who are 70 percent of our doctor force. And only 30 percent are primary care, who would be defined as general internists, family practicioners, OB-GYN -- some OB-GYN -- and all pediatrics. There are only 30 percent. Should be 50, probably 60. I think that's a big factor because these performance measures describe what primary care doctors do a lot. And if there are fewer of them, it's going to fall down.

And then, of course, there's always the issue of ability to pay, which has certainly gotten worse between these two surveys. That is to say, people in larger numbers have no insurance or poorer insurance.

I think that would begin to subsume the explanation. Althought this study does not offer the why of it, they just give you the what.

Every week in Illinois, 18 people needlessly die because they lack health insurance. That is the key finding in a new report by the nonprofit group Families USA. In 2006, the report (PDF) estimates that 960 Illinoisans died for lack of insurance:

In 2006, there were more than 6,648,000 people between the ages of 25 and 64 living in Illinois. Of those, 17.2 percent were uninsured.2 Uninsured Illinoisans are sicker and die sooner than their insured counterparts. [...]

Families USA estimates that more than 18 working-age Illinoisans die each week due to lack of health insurance (approximately 960 people in 2006).

Between 2000 and 2006, the estimated number of adults between the ages of 25 and 64 in Illinois who died because they did not have health insurance was more than 6,100.

As we briefly mentioned in the Early Bird, there is some pretty unsettling data in a new report by the National Low Income Housing Coalition this morning.

Titled "Out of Reach 2007-2008," the report shows that nationally, the gap between low-income Americans and their housing costs continues to widen significantly. While the affordability standard set by the federal government is 30 percent of one's income, one in seven families pays over 50 percent for a roof over their heads.

And at the state level, Illinois ranks fairly low(pdf), reporting the nation's 15th most expensive two-bedroom "housing wage" (including Washington DC and Puerto Rico). Here's the underlying data for Illinois:

In Illinois, the Fair Market Rent (FMR) for a two-bedroom apartment is $844. In order to afford this level of rent and utilities, without paying more than 30% of income on housing, a household must earn $2,813 monthly or $33,758 annually. Assuming a 40-hour work week, 52 weeks per year, this level of income translates into a Housing Wage of $16.23.

In Illinois, a minimum wage worker earns an hourly wage of $7.50. In order to afford the FMR for a two-bedroom apartment, a minimum wage earner must work 87 hours per week, 52 weeks per year. Or, a household must include 2.2 minimum wage earner(s) working 40 hours per week year-round in order to make the two bedroom FMR affordable.

Thankfully, there are advocates pushing hard to ease this burden. While the imitable Leadership Council for Metropolitan Open Communities -- the organization founded after Martin Luther King Jr.'s open housing campaign in 1966 -- folded in 2006, Housing Action Illinois has picked up the slack. You can check them out here.

Image used under a Creative Commons license by Flickr user stevevance.

Over at Illinois Issues, Daniel Vock has a great run-down of the state's progressive accomplishments on immigrant rights. As statehouses across the nation ramp up their nativist rhetoric and strip undocumented immigrants of rights and benefits, Vock shows how Illinois residents and legislators have bucked the trend:

But even if lawmakers scale back the workplace law, Illinois remains one of the friendliest states for immigrants, legal or unauthorized. It’s opened doors to universities and doctors’ offices for children in the country illegally, and it’s made a concerted effort to help legal immigrants become citizens since 1995 [...]

In education, Illinois is one of 10 states that offers graduates of its high schools in-state tuition regardless of their immigration status. North Carolina lawmakers are considering whether to let unauthorized immigrants enroll in community college, which they were banned from doing until late last year.

As Colorado forbids spending on most public benefits for illegal immigrants, Illinois offers insurance to all children, including the undocumented, under its All Kids plan.

Vock points to several factors contributing to the state's strong support of immigrants, including a long history of immigration, Democratic control of state government, and lawmakers' ability to embed immigrant rights policies in universal plans. But most importantly, he cites the organizing of immigrants as a political force. This was a key factor in Bill Foster's victory in the 14th Congressional District special election, as Joshua Hoyt explained in a recent Progress Illinois column:

Dozens of Latino and immigrant activists were working to “Get Out The Vote” for Foster on Election Day and it is well worth noting that Foster carried the heavily Hispanic City of Aurora with a 3,200 vote margin.

Vock also unintentionally highlights an interesting tension in the GOP, both statewide and nationally.

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Illinois families received some encouraging news today: Illinois children fare better now than 20 years ago.

According to a new report from the advocacy organization Voices for Illinois Children, 12 times as many children attend state-supported preschool today and 70 percent more children are covered by public health insurance than 20 years earlier. Fewer kids are dependent on welfare and in foster care as well.

Illinois' focus on early education is important. Among the findings of the Perry Preschool study, one of the nation's most-cited analyses of the benefits of early childhood education, adults at age 40 who attended preschool netted higher earnings, were more likely to hold a job, had committed fewer crimes, and were more likely to have graduated from high school than those who skipped preschool. It's also fiscally sensible; spending $1 now on preschool can save the state $17 down the line on the costs for special education, incarceration, and an under-educated workforce.

There's still lots of work to be done, however. The study singled out the state's treatment of the estimated 300,000 Illinois children with mental health conditions as one area in need of improvement. School funding equity is also a major concern. According to A+ Illinois, "Illinois consistently receives one of the worst grades in school funding equity from Education Week. In 2006 they earned a D+; their ranking of C+ last year followed two years of receiving F grades."