Saturday, November 18, 2017
Will the Senate Act Now to Ensure that Children are Better Not Worse Off After Health Reform?
By Marian Wright Edelman, President (Children's Defense Fund)
Published December 17, 2009

Will the Senate Act Now to Ensure that Children are Better Not Worse Off After Health Reform?

If the Senate doesn’t take a stand for children in the next days or weeks, our worst fears could clearly come to pass. Millions of child lives hang in the balance.

As Congress debates national health reform, providing affordable, accessible and comprehensive health coverage for all children should be a no brainer and a top priority in a moral and economically sensible nation. Instead, as many as 10 million children are in serious danger of being worse off after health reform if the successful and cost effective Children’s Health Insurance Program (CHIP) is abolished as the House bill proposes. And millions of additional children could remain stuck in bureaucratic red tape or continue to be denied essential services because their needs keep being pushed aside by more powerful interests.

The public clearly gets it. A poll released today by Lake Partners and Hart Research found that by a margin of more than 2 to 1, Americans oppose abolishing CHIP. In fact, the majority of Americans strongly agree that they would be less likely to support any health care reform bill that made it harder for 10 million children of low and moderate income working parents to get quality health coverage at an affordable price. A summary of this poll is attached for your reference.

Thankfully, children’s champion Senator Bob Casey (D-PA) has filed an amendment to protect and to improve CHIP for the millions of children whose health and futures depend on it. However, its consideration and passage on the Senate floor or inclusion in the Manager’s Amendment are far from certain despite the fact that caring for children is strongly supported by the American public.

BACKGROUND: The popular CHIP program was enacted in 1997 with the bipartisan leadership of Senators Ted Kennedy and Orrin Hatch to provide health insurance coverage to children in working families not poor enough to qualify for Medicaid, and yet unable to afford private health insurance.

President Obama renewed CHIP in February, after two vetoes by President Bush. At that time he said: “We fulfill one of the highest responsibilities we have: to ensure the health and well-being of our nation’s children.” and “No child in America should be receiving her primary care in the emergency room in the middle of the night. No child should be falling behind in school because he can’t hear the teacher or see the blackboard. I refuse to accept that millions of our kids fail to reach their potential because we fail to meet their basic needs. In a decent society, there are certain obligations that are not subject to tradeoffs or negotiations–health care for our children is one of those obligations.”

We could not agree more.

Yet ten months later, as Congress debates and prepares to vote on urgently needed national health reform for all, the House of Representatives has approved a bill that abolishes the proven CHIP program and would turn millions of CHIP children over to a new, untested, more expensive Health Insurance Exchange the day the system becomes operative (January 1, 2014). This new Exchange will be driven largely by insurance companies and will fail to provide the cost sharing and benefit protections CHIP children currently enjoy. Millions of CHIP-eligible children would be worse rather than better off as parents are forced to pay more money for fewer benefits.

CASEY AMENDMENT: Congress has a chance to right this wrong by supporting what the majority of Americans strongly support (53%)–an amendment to the health reform bill to protect and improve CHIP. Senator Casey’s amendment would:

1. Fully fund CHIP through 2019 and establish an affordable national health safety net for all children in working families with incomes between $30-55,000 (133-250% of the federal poverty level). Thirty-one states and the District of Columbia already have 250% eligibility, and that should become a national standard given that the annual premium for family health coverage purchased through an employer is $13,375.

2. Guarantee that children have access to the full range of health and mental health benefits they need, now provided to all children in Medicaid but only some children in CHIP. All children are of equal value and they deserve equal protections and equal access to all essential services. That’s why three-quarters of Americans favor “including a provision in health care reform to ensure that children in all states receive medically necessary health and mental health services in the CHIP program.”

3. Cut the red tape that keeps about 2 out of 3 of the more than 8 million uninsured children already eligible for CHIP or Medicaid from actually getting the care they need. A simple, seamless enrollment process would ensure children are covered and cared for. For years, officials in every state have said they would fix the problem but far too few have actually done so. The Casey amendment will ensure that best practices in enrollment that we know work are actually implemented. We have found a way to automatically enroll all older Americans in Medicare–and 74% of Americans favor simplifying the enrollment process so that all eligible children are enrolled in CHIP and Medicaid and actually get the coverage they need and deserve.

More than 600 national and state organizations representing health and mental health, education, faith, civil rights and more join CDF in strongly supporting Senator Casey’s amendment.

In describing his priorities for health care reform, President Obama promised that people who are satisfied with the health coverage they currently have should be able to keep it. An overwhelming majority (79 percent) of the public believes that this principle should certainly apply to children in CHIP. Senator Casey has rightfully said that we are not asking seniors to give up their Medicare or veterans to give up their care through the Veterans Administration and move into the Exchange. We should not ask children to give up CHIP.

To learn more about Senator Casey’s Children’s CHIP Amendment, please do not hesitate to contact Alison Buist, CDF’s Director of Child Health at 202-662-3586; or MaryLee Allen, Director of Child Welfare and Mental Health at 202-662-3573;

Categories: Health

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