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For Immediate Release
January 9, 2009
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WASHINGTON, DC - This week the Children's Defense Fund sent the following letter to all Members of 111th Congress regarding SCHIP and options on how to provide coverage for all children in 2009:
The State Children's Health Insurance Program (SCHIP) legislation enacted in 2007 and vetoed by President Bush is not the child health reform needed in 2009. It is imperative that children not only keep health coverage during this severe recession but that coverage be extended to all children and significantly improved either as part of an economic recovery package, as stand-alone child health legislation (SCHIP), or as part of universal coverage. As child poverty and extreme poverty grows, and family job, home and health coverage losses escalate, sound and comprehensive children's health legislation is crucial now. While the Children's Defense Fund favors universal coverage for all, children can be an immediate phase one towards coverage for all, fulfilling President-Elect Obama’s promise of a child health coverage mandate.
A new President and Congress have the ability to provide long overdue health coverage for all children right away and in the right way. As SCHIP comes up for renewal in March 2009 or earlier, we urge you to extend health coverage to all children not the one-third of uninsured children the SCHIP bills passed by Congress and vetoed by President Bush would have provided. As the mother of three children who believes their lives are of equal value, I would never choose between them. Nor should our leaders choose to leave two-thirds of our children outside a health care safety net in 2009.
In 1997, the Children's Defense Fund, and its then affiliate Stand for Children, labored tirelessly to enact SCHIP, working closely with Senators Kennedy and Hatch. We failed to achieve the hoped for coverage for all the then 10 million uninsured children or the comprehensive benefits provided children under Medicaid for SCHIP children. Since then we have worked tirelessly to implement both programs in states and to correct the benefit gaps and bureaucratic obstacles that have resulted in 6 million children currently eligible for these programs not being enrolled, while another 3 million remain ineligible and uninsured and millions more underinsured. Now is the time to correct these inequities and enact sound child health and economic policy at a time of escalating child and family need and economic downturn.
The SCHIP bills passed by Congress and vetoed by President Bush in 2007 do not fulfill President-Elect Obama’s promised children’s mandate of health coverage for all children. Those bills were designed for a different political time. The $35 billion Congress authorized in 2007 to expand SCHIP over 5 years to cover about 3 of the 9 million uninsured children, without benefit reforms, would cover only about 2.8 million children today, leaving 6 million children without coverage. The 2007 legislation is not the desired first phase of health coverage for all children if universal coverage is not achieved in 2009 or what children need in universal coverage. As children need help right now to survive, thrive and learn in school, the Administration and Congress can achieve sound child health coverage in 2009 in the following ways.
Option 1: Enact an expanded and improved SCHIP bill in January as part of an economic stimulus package or as stand-alone legislation later that: (1) covers all 9 million uninsured children and 800,000 uninsured pregnant women; (2) has a national eligibility floor for families with incomes up to 300% of the federal poverty level ($63,000 for a family of 4), with the ability of families above that level to buy in at affordable cost; (3) includes a comprehensive guaranteed benefit package that allows all SCHIP children to receive all the medically necessary services now provided by Medicaid (EPSDT); and (4) simplifies the system through measures like automatic enrollment and removing all bureaucratic barriers that impede children getting and staying enrolled. These steps would eliminate the unjust lottery of geography which permits some states to do as little as possible to protect children’s health and other states to do much more. Children in New York State get assistance up to 400% of the federal poverty level; New Jersey 350%; and eight states 300%. North Dakota children are helped only if their family income is below 150%. Every child's life is of equal value whether they live in Massachusetts or Texas. Yet a Texas child is more than 4 times less likely to be insured as a Massachusetts child. This is wrong and unnecessary. If every senior citizen has a national health safety net, why not every child? An 18 24 month SCHIP renewal could phase in all children and pregnant women and begin implementing all necessary eligibility and benefit reforms.
Option 2: Extend SCHIP funding through 2009 with enough money to cover state shortfalls so that no currently enrolled child loses coverage and more states do not cut back on child coverage. This will give the new Administration and Congress more time to pass a comprehensive and greatly improved child health bill either alone or as part of universal coverage.
What should not happen under any circumstance is that children's health fates are left to 50 different states without guaranteed coverage and benefit protections in two separate programs. I am deeply disturbed that much of the language about universal coverage assumes we will keep both children's Medicaid and SCHIP in some form similar to the current structure. It is crucial that all children and pregnant women be guaranteed a national health safety net that meets their needs in an equitable, comprehensive way. There must not be one system for seniors and one for adults, with children left to a 50-state lottery of geography. Putting children first and mandating coverage and all medically necessary services is our nation’s challenge and responsibility in 2009.
My colleagues and I will be happy to answer any questions you may have and look forward to working with you in the 111th Congress.
Marian Wright Edelman
President, Children's Defense Fund