In 2009, President Obama signed into law a massive expansion of the Children's Health Insurance Program (CHIP). In February, Secretary of Health and Human Services Sebelius announced the Connect Kids to Coverage challenge, aimed at covering 5 million children who are currently eligible for Medicaid or CHIP but are not enrolled. And now, that effort is in high gear with a diverse coalition of the federal government, states, and community groups working together.
The funding for these outreach efforts is provided by the CHIP reauthorization as well as the health reform law passed earlier this year.
Together, the Children’s Health Insurance Program Reauthorization Act (CHIPRA) and the Affordable Care Act provide $120 million for grants designed to promote enrollment and retention strategies that will increase the prevalence of health coverage.The good news is that thanks to a research paper in the Health Affairs Magazine, the HHS now knows where to target.
- Ten states had participation rates at or above 90 percent
- Thirty-nine percent of eligible uninsured children (1.8 million) live in just three states—California, Texas, and Florida—and 61 percent (2.9 million) are concentrated in ten states.
One of this Administration’s key goals is to fulfill the CHIPRA legislation – which the President signed as one of his first acts in office – to ensure that all children who are eligible for Medicaid and CHIP are enrolled in coverage and stay enrolled for as long as they are eligible.During the health reform debate, much was debate within the progressive left about the loss of a public option. But surprisingly little attention was paid then -- and is paid now -- to the efforts and successes of this administration to expand coverage within existing public health insurance programs. Not only would a successful conclusion of the Covering Kids Challenge cut the number of uninsured children in America by 65%, it would enroll those children in solid public insurance programs - one might say a single payer alternative to the private marketplace.
CHIPRA, combined with the American Recovery and Reinvestment Act of 2009 (ARRA) and its recent extension of increased federal Medicaid funding, has given states unprecedented federal support that has enabled them to keep providing essential health services for low-income families through Medicaid during the economic downturn.
But this program isn't a done deal. It doesn't simply depend on states and community groups joining the effort to get children covered. If the Republicans win either house of Congress this November, they have told us what they'll do: they'll shut down the government. And just what happened to the HHS, the Department responsible for connecting our children to good public health insurance coverage, when there was a Republican-forced government shut-down in the 1990s? As one of my favorite Daily Kos diarists, Geekesque, reminded us today, TPM discusses the un-American results of a government shut-down:
"It was a mess frankly, and devastating to the civil service," said Donna Shalala, who served as Secretary of the Department of Health and Human Services during the last government shutdown, which ran from December 16, 1995 through January 6, 1996. "It seems to me it's un-American."Just who do you think will work on this implementation and distributing the grant monwy when HHS employees are sent home because they cannot be paid? Not only would there be no one to work on the implementation, the actual programs would get hurt too.
"Almost all employees are sent home," says former Labor Department Secretary Robert Reich, who served alongside Shalala. "Most have no idea when they'll be paid again."
According to a 2004 report of the Congressional Research Service, "Government shutdowns have necessitated the furloughing of several hundred thousand federal employees and affect all sectors of the economy."
"Social Security checks, Medicare reimbursements...welfare checks to the state, Medicaid checks to the state."We cannot let them do this. We cannot let Republicans keep us from covering children with health insurance - which, I guarantee you, the love-the-babies-till-they-are-born party will do if given the chance.
We cannot give them that chance. When I say that we must work like hell to win in November for the sake of America's children, I am not speaking metaphorically; nor am I just speaking of the future. I am talking literally and immediately.