Congress could leave millions of children without health care
While Republican leaders in Congress and the White House figure out their next moves on repealing and replacing the Affordable Care Act, it is important to not lose sight of another major program that faces a funding deadline: Sept. 30 is when funds run out on the Children’s Health Insurance Program (CHIP).
If Congress fails to act by this date, funds that flow from the federal government to the states will eventually dry up, as soon as early 2018, leaving millions of children without health coverage.
While not as well-known as Medicare or Medicaid, CHIP has been vital for providing health coverage for children in families that make too much to qualify for Medicaid, but not enough to afford health insurance. It is every bit as important as the other two programs in forming a safety net that protects people and families.
And unlike the entitlement programs that many conservatives find so objectionable, because they provide a benefit without any attached responsibility, CHIP is helping working families; it is keeping people employed and contributing tax dollars.
How we got here
As of last year, CHIP covered 8.4 million children nationwide. Like Medicaid, it is state-administered but jointly funded with the federal government. The federal government contributes a higher percentage of the cost of the program than it does with Medicaid. In my home state of Massachusetts, the federal government picks up 88 percent of the cost of the program.
The program is a relative bargain for the federal government, costing $9.7 billion in Federal Fiscal Year 2015. When one considers the early medical screenings and primary care the program provides to a population that otherwise would have no access to it, the true cost is likely considerably less. Screenings and well-child visits identify potential issues early on, lowering the treatment cost because these issues are caught early.
According to the Kaiser Family Foundation, the percentage of children getting well-child checkups is in the mid-80 percent range for those with public and employer-sponsored insurance. That rate drops to just over half for the uninsured. Without CHIP, children will miss out on key preventive care, and that will set them and their families back considerably.
The program helps children maintain their health, but it does something even more important: by identifying medical and developmental issues up front, it enables the success of children in school, and that early success can be the difference between being trapped in, and leaving, a cycle and family history of low-income employment.
Most people, conservatives and liberals alike, support using government dollars to invest in people, enabling them to overcome obstacles, achieve educational and vocational goals, and become meaningful contributors to society.
Giving people access to health care is so much more than ensuring people get medical attention when they need it. It puts them on the same footing as those with higher incomes and it gives them the same set of opportunities.
When it comes to children, the notion of a health care “investment” comes into even sharper focus for two reasons: children generally cost much less to cover than adults and seniors; and if we must justify children’s health care according to a bottom-line formula, the return on that investment gets paid out over many decades.
A child helped by CHIP who is able to perform well in school and meet their growth and development milestones, will likely have four decades of contributing to our economy and the strength of our nation before becoming eligible for any kind of government “assistance” in the form of Medicare or Social Security.
Compare that to the child who has an undiagnosed vision deficit or hearing impairment who cannot keep up in class, falls far behind, and eventually drops out of school. They are exponentially more likely to depend on the government sooner.
Before CHIP’s creation two decades ago, children in low-income working families routinely had no access to primary care. When they got very sick, they presented at hospital emergency departments requiring high cost care.
CHIP has opened up a new world to these children and their families. They are able to manage chronic illnesses which are more common among lower-income families, such as asthma, staying healthier and experiencing fewer missed days of schools. CHIP has narrowed a health care disparities gap.
The rate of uninsured children has fallen from 14 percent to five percent over the last 20 years.
Yes, we have more work to do in getting that five percent down further, but moving in the opposite direction, which will surely happen if Congress fails to re-authorize CHIP, and fast, will greatly undermine children’s health care in America.
It will also undermine the success of welfare reform, as more low-income families realize that welfare and its Medicaid benefit are their only avenue to health care coverage. And it will create needless suffering among families, and their children, looking merely for a hand up — an even shot at finding success as those with higher incomes have.
Congress needs to prioritize passage of the CHIP re-authorization. It needs to acknowledge the success of this relatively low-cost program — and the vision that led to its creation in 1997 — in fulfilling values of equality that our nation holds dear.
Gerard A. Vitti is the founder and CEO of Healthcare Financial, Inc.
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