Let’s Make Health Care Reform Work For Low-Income Children

As I wrote awhile ago, the current health care reform bills could leave many low-income children worse off than they are now. The children at risk are some portion of those who are currently enrolled–and others others who should be enrolled–in the State Children’s Health Insurance Program.

Those whose families are poor enough will have a broad range of very low-cost benefits through Medicaid. Not-quite-so-poor children now enrolled in SCHIP will be shifted to the health insurance exchange–immediately under the bill the House passed and in 2013 under the bill the Senate is debating. And that’s where the problems lie.

Plans purchsed through the exchange will have considerably higher premiums and out-of-pocket costs. And neither the House nor the Senate bill requires them to cover all the health services children need.

Moreover, just because the Senate bill would temporarily extend SCHIP doesn’t mean that all eligible children would be covered. According to a Kaiser Family Foundation brief, most of the 8.9 million children without insurance now are eligible for a public health care program. The Congressional Budget Office estimates that SCHIP and Medicaid combined will cover only 5.6 million more children in 2013.

Nor does the current Senate bill mean that children in SCHIP will get adequate health care. The Children’s Defense Fund has called the current system “an unjust lottery of geography”–in part because some states operate SCHIP programs that offer less than the comprehensive screening, prevention, diagnosis and treatment services available under Medicaid.

Senator Bob Casey (D-PA) has introduced an amendment (#2790) that would address these problems. As his summary indicates, it would:

  • Continue federal funding for SCHIP through 2019.
  • Require the U.S. Department of Health and Human Services to report on differences between coverage under subsidized plans in the exchange and coverage under SCHIP, thus giving Congress a basis for deciding whether to preserve SCHIP beyond 2019.
  • Require states to offer the same range of services to children in SCHIP as they cover under Medicaid.
  • Provide federal matching funds for all covered services SCHIP children receive instead of giving states a predetermined grant for each year.
  • Prohibit states from reducing income eligibility standards for SCHIP and require them to cover all children up to 250% of the federal poverty line, beginning in 2014.
  • Ensure that SCHIP remains affordable by prohibiting states from increasing charges, except to reflect increases in the median income for low-income families.
  • Provide grants and a significant financial incentive for states to increase outreach and streamline their  enrollment process.

Voices for America’s Children has a customizable e-mail that those who have Senators can use to support this worthy amendment. We who live in Washington, D.C. can call or e-mail Senate Majority Leader Harry Reid, since he will reportedly will incorporate changes he likes into a final manager’s amendment.

The leadership is pushing to get something passed before Christmas. So time is of the essence here.


One Response to Let’s Make Health Care Reform Work For Low-Income Children

  1. mcadoo11 says:

    Kathy, fantastic piece! It truly is an outrage that Congress passed and the President signed into law the CHIP reauthorization bill just months ago and now are preparing to repeal or underfund it while also creating a Medicare buy-in program. Why do kids always get short-changed?

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