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Casey: Kids Overlooked in Reform Debate

Many of the headlines in the health care reform debate have bypassed a very important group that is too often overlooked: children. Throughout health care reform, my top priority was to ensure that no child was left worse off by our efforts and that we improve health care for children. The Senate-passed bill meets this test and would improve care for millions of children.

During health care reform, I wanted to ensure the integrity and strength of the highly successful State Children’s Health Insurance Program, originally a state program in Pennsylvania. SCHIP has been a 12-year national success story that has provided coverage to more than 7 million low-income children, and it is on track to cover a total of 14.1 million children by 2013. SCHIP guarantees that children in low-income families who do not qualify for Medicaid, but cannot afford private health insurance, have access to health care. After repeated vetoes by former President George W. Bush, Congress in early 2009 passed and President Barack Obama signed into law a reauthorization of SCHIP through 2013.

There is no question that this is a program that works. SCHIP has cut the rate of uninsured children to less than 10 percent, compared with 20 percent or more for adults. According to the U.S. Census Bureau, in 2007 and 2008 as the country entered the recession and the number of families living in poverty increased, the uninsured rate for children dropped even as the number of uninsured adults increased. SCHIP, along with Medicaid, is part of a strong safety net for children that works and protects their health and well-being. Every child is born with a light inside them. For some children, the reach of that light will be boundless; for others, that light will be a little more limited. No matter how brightly that light is shining, we have to make sure we are there for every child, especially when it comes to health care.

So, as Congress engaged in what has become a yearlong debate on how to reform our nation’s health care system, I worked to ensure that SCHIP would be protected. To this end, I introduced an amendment to the Senate health care reform bill that would fund SCHIP through 2019. While the final Senate bill does not currently contain the entirety of my proposal, some improvements were made.

SCHIP funding will be continued for two years beyond its previous end date of Sept. 30, 2013. This funding ensures that children can keep their SCHIP coverage during a critical period when health reform is just getting off the ground. States will still need to maintain current Medicaid and SCHIP eligibility and enrollment procedures for children above 133 percent of the federal poverty level through fiscal 2019. However, states must meet this “maintenance of effort” requirement or lose their Medicaid funding. This will ensure that the safety net that has been created by SCHIP remains in place and that continuity of care for kids with SCHIP coverage is not compromised.

The secretary of Health and Human Services will be required to review and certify which plans in the exchange provide SCHIP-comparable benefits and cost sharing. Children should not be required to move to the exchange unless the benefits provided are at least as good as, if not better than, the benefits provided by SCHIP. After the new coverage system is established by health care reform legislation, Congress can make an informed decision about whether to move SCHIP children into the exchange. In the meantime, the popular and successful SCHIP will continue to serve millions of low-income children, without forcing them into a new and untested system of coverage that would dramatically raise their health care costs and reduce covered benefits.

Obama’s recent proposal, based on the Senate-passed Patient Protection and Affordable Care Act, recognizes the important role SCHIP plays in insuring America’s children: States would be required to maintain eligibility through 2019, and funding is extended through 2015. Starting in 2016, states would receive a 23 percent increase to their SCHIP matching rate to ensure that they are able to continue offering affordable coverage to children.

We have made a good start, but we still have a lot of work to do to ensure that children, and their families, have access to comprehensive and affordable health care. Our children deserve nothing less than the best we have to offer so that the light inside each child can continue to shine brightly.

Sen. Bob Casey is a Democrat from Pennsylvania.

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