Health care reform works

Opinion: September 19, 2011 at 12:00a.m.

By O. MARION BURTON

McClatchy-Tribune

As a pediatrician, I see firsthand how families struggle in difficult economic times. Our children are hurting, and parents try valiantly to make ends meet — this includes paying for the health care their children need to grow into healthy adults.

Federal programs exist that can help parents ensure their children are healthy. Medicaid and the Children’s Health Insurance Program (CHIP) are bedrocks for children’s health, and have provided a critical way for millions of children to receive age-appropriate benefits in partnership with their pediatricians and their families.

Higher enrollments

A new study conducted by the Urban Institute estimates the number of children in Medicaid and CHIP increased in 30 states between 2008 and 2009, with 16 states achieving enrollment rates of 90 percent or higher in 2009. Yet, while the number of eligible but uninsured children fell by about 340,000, there are 4.3 million children who are still eligible for these public programs but not enrolled.

To increase coverage for children, bureaucratic and other barriers to enrollment must be eliminated. The Obama administration has released a new regulation to streamline Medicaid eligibility and take steps to coordinate existing programs with the new health insurance Exchanges being created by the Affordable Care Act. The administration’s proposal would coordinate Exchange enrollment and Medicaid/CHIP enrollment, meaning that families will have “no wrong door” when trying to find health insurance.

With the ACA and this new enrollment regulation, states now have increased flexibility to receive federal help, which will strengthen Medicaid programs in states and help children who currently make up the largest population of Medicaid beneficiaries. Parents who go to the Exchanges or use current ways to apply for Medicaid and CHIP will now have a streamlined application process that uses modern technology to make renewing each year much easier. States will have help to more efficiently determine which insurance offerings families qualify for, and Medicaid eligibility will be streamlined into four primary coverage groups (children, pregnant women, parents and adults) rather than the 20 categories that now exist.

The ACA may not be perfect, but this regulation is evidence of a direct positive impact this law is having on the most vulnerable of populations. These changes will significantly cut red tape for states and allow families provide their children with coverage for the health services they need.

Preventative care

Pediatricians know that children with health insurance are more likely to get the preventive health care they need for healthy development, including immunizations and regular checkups. Studies have shown that children with insurance are healthier, perform better in school and become more productive members of society. There is overwhelming scientific evidence that adult illnesses such as depression, cardiovascular disease, pulmonary disease, and some cancers are directly attributable to poor health beginning in childhood.

Our nation can save billions of dollars in the future by preserving and increasing our commitment to children’s health now. Making it easier for families to enroll in public programs like Medicaid and CHIP increases the quality of care and reduces the cost of our over-burdened health care system. This is progress that we should all embrace.

O. Marion Burton is president of the American Academy of Pediatrics, Washington, D.C.