Note to Congress: Don't Forget the Kids

Just over one year ago, members of Congress were patting themselves on the back for the re-authorization of the Children's Health Insurance Program (CHIP) through 2013. Now, no one is sure what to do with it. The popular and successful program might be used as a bargaining chip for more comprehensive health care reform.

Under the House reform proposal, CHIP would be scrapped completely at the end of fiscal 2013 with kids' coverage being shuffled into either expanded Medicaid coverage or insurance exchanges along with their parents. The Senate proposal offers an additional two years beyond 2013, while President Obama's most recent compromise holds firm for full program funding through 2016.

While CHIP supporters acknowledge that the continuous renewal of the program's funding would subject it to the political whims of the day, research has shown that children and their families are much better off under the federally funded plan. A study last year by Watson Wyatt Worldwide, an actuarial research firm, found that families living between 175 and 225 percent of the federal poverty level pay less than two percent of medical bills under CHIP. If forced to use private exchanges, those same families would pay up to 35 percent of their children's health costs.

The Congressional Budget Office also agreed with this analysis, stating that the higher costs of exchanges may leave children uncovered.

"For any who had doubts, this study confirms that children currently enrolled in the Children's Health Insurance Program have the best, most affordable care," said Bruce Lesley, President of First Focus, who commissioned the study.

While the 2009 CHIP re-authorization has resulted in the addition of 2.6 million children to the program, there are still an estimated seven million who are uninsured with almost five million of those eligible to join either Medicaid or CHIP. Health and Human Services Secretary Kathleen Sebelius launched a campaign in February, known as Connecting Kids to Coverage, to find and enroll these children.

In addition, to make sure the care provided is meeting quality standards, Sebelius announced last week the award of $100 million of grants to ten states. The money will help states implement and evaluate provider performance measures and utilize health information technologies such as pediatric electronic health records and other quality improvement initiatives. The funds were included in the re-authorization act.

"These awards will help create the foundation for a more responsive and effective national system of high quality health care for children," said Cindy Mann, director of the Center for Medicaid and State Operations within CMS.

And that is the bottom line: continued, affordable, quality coverage for those patients who are the most vulnerable. We should not settle for anything less.

Photo credit: Divine in the Daily