Although health insurance for children was prioritized
earlier this year with the federal reauthorization
of the Children’s Health Insurance Program (CHIP), and again now as our Governor appears poised to sign
a bill that restores funding for the Healthy Families
program, the fact still remains that millions of children
continue to fill the rolls of the nation’s uninsured.
So as members of Congress and the President continue
their work on health care reform and their fight over
issues like the public option, death panels, individual
mandates, and myriad other controversial reform issues
that seem to be dominating the political and public
debate, they need remember first and foremost their
responsibility to finish the job of providing coverage
for all our kids.
In negotiating the components of the final health reform
package, members of Congress need to address the following
1. Universal Children’s Coverage
Currently, six million children are eligible but not
enrolled in public coverage programs nationally.
Eliminating red tape and bureaucracy by simplifying
the enrollment process is the most cost-effective, quickest, smartest and most cost-effective initial step toward ensuring that the lowest-income kids are insured.
Any health care reform plan must leave parents a hassle-free way to secure coverage for their children through
a “No Wrong Door” system that links them to any public program for which
In addition, for children eligible for Medicaid or
CHIP, lawmakers need to ensure that children will receive
either comparable or better benefits, cost-sharing protections, and access to care under any new
CHIP and Medicaid have cost-sharing protections, and Congress must ensure that
children do not lose these under any new program.
2. Assure Children’s Access to Quality Health Care
Health reform must also address inadequate access to
care by covered children.
Although Medi-Cal covers 27% of California’s children, inadequate payments limit access to health
Poor payment by California Children’s Services, which covers illnesses such as cancer and
diabetes in children, has led to severe shortages of
pediatric subspecialists in California.
By federal law, Medi-Cal is required to provide access to health care equivalent
to that of the general population; however, payment cuts are proposed without regard
to the impact on patient access.
The federal equal access law needs to be enforced.
Beyond reimbursement, successful models such as the
medical home should be implemented.
For example, North Carolina’s Medicaid program achieved savings of $170 million in 2006 alone by supporting medical homes that have supported
physician-led improvements in care that reduce ER visits and
3. Comprehensive Children’s Care
Real reform also means meeting the overall developmental
needs of children, and providing access to comprehensive
services, which not only includes primary and preventative
medical care, but also oral and mental health.
Congress established the Medicaid EPSDT program when
the military rejected many young men from service because
of preventable disabilities that were not identified
and treated in childhood.
Limits on health benefits are unacceptable for a country
that wants its children to recognize their full potential.
4. Promote Wellness and Prevention
Our ultimate goal is to improve health itself.
Thus, promoting wellness and prevention is essential
Promoting wellness includes receiving a quality education,
which is strongly linked with better health.
Eating and physical activity habits formed during childhood
may lead to obesity and related illnesses, estimated
to cost California $21.7 billion a year in 2000.
Access to quality food, parks, and physical education
are essential to addressing this crisis.
Clean air and water are also critical for the health
Children exposed to particulate pollution develop the
lung disease emphysema at an earlier adult age. Let
us also not forget that California’s investment in smoking cessation saved $86 billion in personal health care costs.
All eyes are on Congress right now to enact the real
health reforms that so many of California’s kids so desperately need.
We cannot afford to let another generation suffer from
While we debate the role of government in health care,
I hope we can all agree that children’s health is our top priority. Congress must get federal
health care reform right this time because there are
no second chances when it comes to childhood.