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As a pediatrician, I see the best and the worst of our health care system.  I see very ill children whose families cannot afford to get them the medicine or treatment they need. I see children who have not received basic preventive care and who are sicker than they should be.  I see children who have untreated chronic illnesses, like asthma and diabetes, making daily life more challenging than it should be.

Beginning this week, new protections created by national health reform will make health insurance start working better.  The first provisions of the new law will go into effect on September 23rd.  They require that private health plans:

  • Stop excluding children with pre-existing health conditions;
  • Allow parents, during open enrollment, to maintain health insurance coverage for their children who don’t have access to employer based insurance up to age 26, regardless of where  they live and whether or not they are married or full-time students;
  • Provide preventive health care services without co-pays (this may only apply  to new health plans); and
  • Eliminate the caps on children’s coverage so that they can’t be dropped from health plans when they get sick and so that insurers will no longer limit the costs of lifetime coverage.

These new protections mean that children can live healthier lives; that families need not fear the possibility of bankruptcy when faced with expensive, prolonged treatments for serious illnesses; that young people in college or in their first jobs needn’t worry if they get sick.  Children with chronic, treatable conditions can be spared crisis trips to the Emergency Room, because they are now entitled to ongoing coverage that can manage and stabilize illnesses.

California must take advantage of this new law.  The first step calls for the Governor to add his imprimatur to a new era of health coverage. He should immediately sign the two bills on his desk that will create California’s “Exchange” – a marketplace where health insurance will be available to everyone by 2014.

Second, policymakers, parents, teachers, doctors and nurses, health plans, and employers, must make sure that the new system works efficiently and that families understand how to use it to protect their children.

In addition to these positive new changes, we must make sure that families who cannot afford health insurance know that there are programs available to help them today. California’s Medi-Cal and Healthy Families programs offer preventive services, mental health care, doctor visits, even hospital coverage for more than a million California children who are eligible. Sadly, about 700,000 of those eligible kids aren’t enrolled in these programs. Why? We must do a better a job of reaching out to these families and facilitating their access to health care through Medi-Cal and Healthy Families.

By taking the courageous step of establishing California’s health insurance Exchange, by insisting on the implementation of these important first September 23rd health care protections, and by stepping up to the plate to maximize enrollment in successful, existing programs, there is the promise of a new day for California’s children.

A day when all kids can start school on time because they’ve received check-ups and immunizations, when all children can breathe easy on a soccer field and run and kick their way to wellness, when young minds can stay sharp and curious because they are free of infection or illness, when families do not have to choose between groceries and a visit to the doctor.

And for me, as a pediatrician, I can see the day when the children who come to my office have a fighting chance to be healthy.

This is the moment to make that vision a reality.

Laura Mabie, MD

Board Member and President of the Los Angeles County, Central Coast, and Inland Empire Chapter

American Academy of Pediatrics, California

The American Academy of Pediatrics, California is an organized group of over 5,000 board-certified pediatrician members of all four California regional Chapters. AAP-CA is committed to the attainment of optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults living in California.

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