Child Health


For Immediate Release
July 23, 2009


For More Information Contact:
Ed Shelleby
(202) 662-3602



WASHINGTON, DC—Leading civil rights organizations including the Children’s Defense Fund (CDF), the Asian American Justice Center (AAJC), the National Association for the Advancement of Colored People (NAACP), the National Congress of American Indians (NCAI), and the National Council of La Raza (NCLR) released the following letter urging Congressman Waxman, Chair of the House Energy and Commerce Committee, to incorporate Congressman Bobby Rush’s proposed amendments into the House health reform bill to ensure children receive the health care they need. The groups warned that in its current state, the legislation could make some children worse off than they are now. Since the coalition formed in April of 2009, they have worked collaboratively to realize America’s promise of covering all children, ensuring that health care reform meets the needs of every child in America, especially children of color who are disproportionately uninsured.

Full text of letter included below:

July 23, 2009

The Honorable Henry Waxman
Chair, Committee on Energy & Commerce
U.S. House of Representatives
Washington, DC 20515

Dear Chairman Waxman:

Leading civil rights and children’s groups have joined together to urge that health care reform legislation incorporate three key principles for all children.  These principles focus on affordable coverage, access to comprehensive health benefits, and a simple and equitable enrollment process. However, current legislation in the House of Representatives fails to fully meet the standards set out by these principles and could potentially leave millions of children worse off than they are today.

Representative Bobby Rush has proposed three amendments to the House health reform bill that would ensure that no children would be worse off after health reform. His amendments would ensure that health care is affordable, comprehensive and accessible.  We request your leadership in continuing to support the needs of our nation’s children as an integral part of the health care reform process.

The high number of uninsured children exacts a high health, economic and social toll on these children, their families and our nation. An enormous concern is the fact that the distressing consequences of being uninsured fall disproportionately on children of color, who represent almost two-thirds of all uninsured children. Children of color are at higher risk than White children of having unmet health, mental health, and dental care needs. Lack of access to care can result in different paths for our children from their earliest moments.

Even when the Children’s Health Insurance Program (CHIP) legislation is fully implemented, five to six million children, disproportionately children of color, will still be uninsured. Many of these children will be eligible for coverage under Medicaid or CHIP but not enrolled because of formidable and unnecessary administrative barriers to enrollment. Waiting periods for access to public health programs are determined at states’ discretion and can be imposed on children arbitrarily, including on legal immigrant children for up to five years.  These laws keep millions of children from accessing critical care in a timely way. Representative Rush’s amendments will make the enrollment procedures simpler and streamlined to ensure they don’t deter children from getting the health coverage they need.

Additionally, all children need a benefit package that reflects their unique health care needs and is designed to support their optimal development. This benefit standard should apply to all child health plans—Medicaid and CHIP, to those offered inside and outside the Exchange, and to employers of all sizes. It is unjust to deny millions of children on CHIP the comprehensive benefits we extend to 28.7 million children each year on Medicaid or the national safety net we extend to seniors.  Representative Rush’s amendment represents an important step forward toward this goal.

We recognize the tremendous pressure to pass comprehensive legislation that does not add to the deficit, but limiting the protections guaranteed to children in health reform is neither just nor sensible. Covering all children is one of the smartest, most cost-effective choices our country can make. A year’s coverage for a single working adult costs about three times what it costs to cover a child for the same length of time. We know that investing in preventive services for children and addressing their health problems now is far more cost-effective than ignoring them. Communities incur increased costs when their children are not insured, often because of increased use of emergency rooms and longer hospital stays.  For example, in Arizona, an uninsured child costs the community $2,100 more than a child with Medicaid or CHIP.

Our partnership is committed to realizing America’s promise of covering all children and ensuring that the millions of uninsured and underinsured children are not forgotten during the health care reform debate.  We ask that you consider our principles and incorporate the necessary changes proposed by Representative Rush into health reform legislation to make affordable health coverage available to all children.


Karen K. Naraski
President and Executive Director
Asian American Justice Center
Marian Wright Edelman
Children’s Defense Fund
Hilary O. Shelton
National Association for the Advancement of Colored People
Jacqueline Johnson Pata
Executive Director
National Congress of American Indians
Janet Murguia
President and CEO
National Council of La Raza

Cc:   Members of the Energy and Commerce Committee
Members of the Ways and Means Committee
Members of the Education and Labor Committee
Members of the House Leadership



Coverage Must Be Affordable
Establish a national eligibility floor of 300% of the federal poverty level for all children and pregnant women, with an affordable sliding scale buy-in above that level.

Children and Pregnant Women Must Have Access to Comprehensive Benefits
Guarantee every child and pregnant woman timely access to all medically necessary services and products to maximize health and development with:

  • Emphasis on prevention and early detection and treatment
  • No preexisting condition exclusion or waiting period
  • Appropriate postpartum coverage
  • High-quality, age-appropriate services from providers in their communities
  • Culturally and linguistically competent services to ensure families receive the care for which they are eligible
  • Protection of access to care regardless of race, ethnicity, or national origin

The System Must Be Simple, Seamless, and Equitable
Ensure children get enrolled and stay enrolled in health coverage programs by observing the following program coverage criteria:

  • Short, simple, understandable application—Application forms must be uniformly used, and barriers such as asset tests, waiting lists, and other obstacles that delay or limit enrollment must be prohibited.
  • Automatic enrollment—All opportunities to identify and enroll children should be used, including at birth, enrollment in school, participation in child-serving programs, and in health settings.
  • Presumptive eligibility—An uninsured child should be presumed eligible for coverage at point of service.

Twelve-month continuous enrollment with automatic renewal—Children’s coverage should be guaranteed for a full year regardless of family income changes; renewal processes, including verification of income, must use all available technology to minimize burdens on families.