Peter Roskam’s Health Plan for Uninsured Illinois Children

As an elected member of Congress, Peter Roskam enjoys, courtesy of the taxpayers, an annual salary of $165,200. (He didn’t get a raise this year, but his colleagues received one in every year since 1997, presumably as a reward to themselves for squashing any increase to the minimum wage for you and me). He is also eligible for a retirement plan with a pension of up to 80% of final salary, allowances for personal staff, office expenses, travel and postage, and, of course, a health plan.

Roskam, his wife, and his children are all eligible to receive taxpayer-funded health insurance under the Federal Employees Health Benefits Program (FEHBP). He can choose any one of a couple of dozen different benefit plans depending upon his needs and preferences.

Now Peter Roskam has a plan to meet the health care needs of uninsured Illinois children. Roskam’s plan, as expected, offers neither quite as much flexibility as Peter and his family enjoy, nor quite as rich a benefit package, but that is understandable. But let’s see how the plans stack up: what Pete get’s for his family through FEHBP vs. what an uninsured Illinois child gets under his proposal. (We don’t know, of course, what coverage Roskam has elected, so we have to use a representative plan for comparative purposes).

First, the taxpayer-funded benefit package for Pete and his family:

• Out of pocket maximum per person: $3,000
• Out of pocket maximum for the family: $6,000
• Annual deductible: None
• Emergency room: Covered 100% after $100 copay
• Hospital inpatient: Covered 100% after $150/day copay for the first 5 days
• Hospital outpatient: Covered 100% after $30 copay
• Inpatient surgeon fees: Covered 100%
• Outpatient surgeon fees: Covered 100%
• Other inpatient doctor fees: Covered 100% after $20 copay
• Primary doctor office visits: Covered 100% after $20 copay
• Specialist office visits: Covered 100% after $30 copay
• Outpatient doctor tests: Covered 100% after $30 copay
• Brand-name drug from local pharmacy: 100% after $25 copay
• Preventive dental: Covered
• Restorative dental: Covered
• Orthodontia: Covered
• Vision exam: Covered
• Eyeglasses and contacts: Covered

Now the Roskam plan for the uninsured children of Illinois:

• Out of pocket maximum per person: No maximum
• Out of pocket maximum for the family: No maximum
• Annual deductible: NA
• Emergency room: Not covered
• Hospital inpatient: Not covered
• Hospital outpatient: Not covered
• Inpatient surgeon fees: Not covered
• Outpatient surgeon fees: Not covered
• Other inpatient doctor fees: Not covered
• Primary doctor office visits: Not covered
• Specialist office visits: Not covered
• Outpatient doctor tests: Not covered
• Brand-name drug from local pharmacy: Not covered
• Preventive dental: Not covered
• Restorative dental: Not covered
• Orthodontia: Not covered
• Vision exam: Not covered
• Eyeglasses and contacts: Not covered

Seeing the two plans side-by-side, and having had no small experience in health care, I’d have to say Pete’s plan for Illinois’ children doesn’t look so good. In fact, it seems to me that, by voting against SCHIP, Pete is telling us “I’ve got mine, the rest of you can go fuck yourselves.”

Give Pete a call at (630) 893-9670 and tell him to vote for SCHIP the next time around because you want for your kids the kind of security that we pay for his kids to have.