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By Tom Daschle and John C. Danforth
September 7, 2009
AS THE HEALTH DEBATE moves forward, there’s been a lot of discussion about stakeholders, and possible winners and losers. The insurers? The hospitals? The drug companies?
But there’s one group of stakeholders who no one seems to be talking about, even though for them and for all of us the stakes are the highest: America’s children.
For the last several months, we’ve been working through the Bipartisan Policy Center to find areas for bipartisan consensus on health care reform. And one thing that is clear is that unless Congress makes children’s health care affordable, comprehensive, and simple, children will be the big losers in the health care debate.
Many members of Congress - and many members of the public - think that Congress “took care of children’’ earlier this year when they passed the expansion of the Children’s Health Insurance Program (CHIP). However, even with the CHIP expansion, five to six million children will remain uninsured, and millions more will remain underinsured.
Uninsured and underinsured children cost our communities. A 2007 study in Pediatrics found that communities save $2,100 for every child they insure or keep insured. Uninsured children are eight times more likely to have delayed medical care and too often end up in the emergency room where treatment can be much more expensive than in the doctor’s office. One out of every nine children in America does not have health coverage.
In the coming weeks, we can change that. The president and Congress have a chance to do the right thing. With just three essential targeted investments, we can level the health playing field and guarantee real reform that works for every child in America.
First, all children should be able to afford health care, no matter where they live. Right now, different states have wildly different rules for eligibility for Medicaid and CHIP. For children, it’s like playing the lottery - where you’re born can determine whether you get to grow up healthy. Congress must fix that. In our recently released report “Crossing our Lines: Working Together to Reform the US Health System,’’ we recommend that Americans making under 400 percent of the federal poverty level receive enhanced protections.
To make sure that children aren’t worse off after health reform than they are now, families that make less than 300 percent of the federal poverty level, about $66,000 a year for a family of four, should not have to pay more out-of-pocket expenses and have weaker benefits for their children than they currently do in Medicaid.
Second, Congress needs to make sure children’s health coverage includes all essential services. All children need immunizations, regular vision, dental, and other developmental screenings, and greater access to primary care and mental-health services.
And third, Congress needs to make enrollment in children’s health programs simple. Currently, about two-thirds of uninsured children are actually eligible for coverage, but in part because of needlessly complicated state-by-state barriers, they never get the care they need. In some states, like Mississippi, children have to interview for their health care. In others, they face long waiting periods. Congress needs to put an end to this by automatically enrolling children in health coverage. Part of the reason Medicare covers nearly every senior citizen is because when you turn 65 you are in - unless you opt out. Why shouldn’t the same be true for children’s health care?
We also believe that as important as it is to expand coverage for children, it is essential to reduce the cost of health care. Any expansion of insurance must be accompanied by effective measures to reduce the costs for the system overall.
In the days to come, Democrats and Republicans are going to decide how they will respond to this historic opportunity to provide a level health playing field for children.
We’re willing to bet that each of them has stood up at a fund-raiser or a rally and uttered the words “Our children are our future.’’
It’s true, economically and morally. Now it’s time to make sure that future is a healthy one.
Source: Boston.com
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