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Bruce Lesley's picture

For the first time in American history, adults do not believe that our nation's children will have the opportunities they had to live a happy, healthy, and prosperous life. And over the past five years, the response from our nation's leaders has been to decrease the share of our national investment in children by 12%. When Americans no longer believe in the American Dream, it's time to return to basics. That means protecting the health, safety, and well-being of all our children.

Last year began with great promise for our nation's children. President Obama was elected on a campaign pledge to ensure all children in this country have access to health coverage. Less than 100 days into his term, the President took important strides towards that goal, signing a law guaranteeing millions of children of working parents the right to see a doctor through the Children's Health Insurance Program (CHIP). Everyone supported it--Democrats, Republicans, and Independents--because no one believes that children should be sick, in pain, or without preventive care. The program is an extraordinary success, providing insurance to kids in working families who can't afford $10,000 premiums, let alone co-payments. And although the uninsured rate for adults continues to rise, it is declining in children, recently reaching a 20-year low. This remarkable fact shows that Medicaid and CHIP work. Proponents of the "public option" should know that CHIP is the public option for kids, as it joins Medicaid to provide comprehensive coverage at very low-cost.

However, some in the hospital industry and in Congress want to eliminate CHIP, sending many of the children it covers into the "health insurance exchanges." For those making a profit in health care, the hope is to make more money on kids through these new exchange plans. For others, the gamble is that moving millions of children into the exchange will subsidize coverage for other populations entering a new, untested system because children are cheaper to insure than adults. They believe that the "greater good" warrants adults to benefit in the new system even if children are left worse off. Sadly, the debate over the health coverage for millions of children has little to do with what is actually in their best interest.

According to a comparison of CHIP to exchange plans proposed in the House and Senate health reform legislation, CHIP has the best, most affordable care. In fact, if children are moved into exchange plans, out-of-pocket costs would increase dramatically. The analysis, conducted by Watson Wyatt Worldwide for First Focus, finds that these out-of-pocket costs would increase by anywhere from 350 to 1,500 percent. Indeed, such a change is not in our children's best interest.

In a recent Philadelphia Inquirer story, a number of families whose kids currently have CHIP coverage were interviewed. Many fear they cannot afford coverage under the new system. In other words, not only will many families face a tremendous increase in cost if moved from CHIP to exchange plans, but others would not be able to afford it, simply losing coverage altogether.

Congress was told much the same by the director of the Congressional Budget Office (CBO), Douglas Elmendorf, when he determined that Senator John D. Rockefeller's amendment toprotect CHIP from being terminated would reduce the number of uninsured children. As he wrote in his director's blog, "CBO expects that offering continuity of coverage for several million children in CHIP would keep some children insured who would not have been covered under the Chairman's mark; under the mark as it was originally offered, which would have eliminated CHIP, CBO anticipated that some of those children would be eligible for subsidized coverage in the exchanges but would not be enrolled in an exchange plan (owing at least in part to the higher premiums and higher out-of-pocket costs that they would typically face in such a plan)."

There are also concerns that states such as California might choose not to take up children's coverage any longer due to its fiscal crisis. However, in the midst of the current recession, 23 states decided to expand CHIP coverage despite facing enormous budget pressures. This is precisely because they responded to the need. Every state in this country has expanded coverage through CHIP and many have dramatically reduced their number of uninsured. Even in the catastrophic circumstance that California is still mired in a recession when the health insurance exchanges begin operating in 2013, the state could opt to move its kids to the exchange whether or not CHIP exists. Sacrificing the CHIP program at the hands of California's economic woes is an irresponsible course of action. Other states should be allowed to continue providing high level and low cost coverage of their state's children through CHIP. For example, Massachusetts has achieved virtually universal children's coverage through CHIP, so why would Congress prohibit it and other states from continuing to do better for our nation's children? We should never gamble in such a way with children's health care.

Our nation's young people have the right to see a doctor, be healthy, and strive to fulfill their God-given potential. No one believes that children should be without vaccinations and annual check-ups just because their parents have lost their job or can't afford insurance despite working full-time.

Health insurance for children of working parents needs to remain a stand-alone program just like Medicare for seniors, so that children don't end up worse off under health care reform. Their parents could then buy insurance for themselves without having to pay excessive premiums to cover their families that there's just no way for them to afford. All of our nation's children deserve the chance to grow, thrive, and live long, healthy lives. Indeed, health reform should at the very least ensure that, in the words of Senator Bob Casey, "no child is left worse off."

President Barack Obama made signing the CHIP legislation one of his first priorities last year. Congress must make sure he fulfills that commitment to "build on what works" by protecting CHIP for the millions of children that rely upon its coverage.

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