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So far, the news about kids in health reform has been dominated by a fat baby and an underweight toddler.  Earlier this month, we learned about a healthy 4-month old boy, Alex Colorado, who was denied coverage by Rocky Mountain Health Plan for being “overweight.”  A week later, we heard about a two-year old Colorado girl, Aislin Bates who was denied coverage because she didn’t weigh enough.  With these inexplicable denials of coverage, the health insurance industry inflicted another wound on itself and secured the adorable Alex and Aislin lots of well-deserved national news coverage.  But, as important as it is for health reform to crack down on the abuses of the health insurance industry, there is much more that also will need to be done to ensure that all of our children and families have guaranteed access to affordable, high-quality health care coverage.

Children have an enormous amount to gain from successful passage of a strong health reform bill –their health, well-being, and the financial security of their families rest upon it.  Yet, the issue of how children fare in health reform has received little attention.  It could be that people erroneously think we are “done with kids” because of the successful reauthorization of the Children’s Health Insurance Program (CHIP) in February of 2009.  And, it is true that CHIP has been successful.  It, along with its larger companion program, Medicaid, has a proven track record of covering kids. Just last month, the Census Bureau reported that these programs had helped to drive the uninsured rate of children to its lowest level in over twenty years.

CHIP, though, was never designed to cover all children; instead, this relatively modest program was intended to serve as a bridge to broader health reform. Now, Congress can’t figure out whether or not to take the “bridge” down, especially because the coverage on the other side might not be so great. If you watched any of the Senate Finance Committee’s mark up of its health reform bill, it was easy to see the struggle.  The committee had been planning to move millions of kids from Medicaid and CHIP into the new “Exchange” plans.  At the last minute during committee mark up of the bill, Senator Rockefeller stepped in with an amendment that sought to bring a screeching halt to these plans and “saved” CHIP.  (One of his arguments was that families would have to pay much more for Exchange coverage than CHIP, a concern validated yesterday by the Congressional Budget Office).  The glitch is that the Rockefeller amendment didn’t actually fully fund CHIP or re-vamp it for health reform; instead, it kicked these critical questions down the road by calling on Congress to act in the years ahead.

Sound like a mess?  It is and I think we can do better for our kids, especially in the context of a $829 billion bill to fundamentally alter the health care system in this country. Not only can we get rid of the abuses of the insurance industry against fat babies and skinny toddlers, but we also should continue CHIP (with funding) at least until the new Exchange plans are up, running, and clearly able to provide children with comparable coverage. It is quite possible that CHIP could safely be disbanded at that point, but until then, children in working families need a safe, secure home for coverage.  More importantly, no matter what happens to CHIP, millions of our kids are going to be in Exchange plans with their parents.  We know that these children will fare better and their families will have more financial security if the entire family has good coverage. This means strong affordability protections and decent benefits for the many millions of families who will rely on the Exchanges for their coverage.

Kids do have a few things going for them in this debate, including that the public considers it a top priority that health reform provide children with the coverage that they need to grow and thrive.  (There is lots of elaborate polling and focus group research on this point, but it seems to boil down to a pretty basic sentiment of, “They are kids, for God’s sake.”) Plus, MomsRising, an online community committed to creating a more family-friendly world, has just launched a campaign to make it easy for all of us who care about kids in health reform to raise the profile of these issues. They are “pinning” members of Congress with pacifiers to deliver the message that moms, kids and those who care about them won’t be pacified until health reform that works for families is passed.  It is a great chance to speak up for kids and it comes at a critical moment in the health care debate.  If you are a parent, grandparent, aunt, uncle, friend, or simply fan of a kid, now is the time to speak up for them in the health care debate.

Jocelyn Guyer is co-Executive Director of the Center for Children and Families at Georgetown University's Health Policy Institute and a mom of three young boys.  This blog entry represents the personal views of Jocelyn Guyer and not the views of the Center for Children and Families.

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