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Congressional Health Reform Bill Falls Short on Comprehensive and Affordable Coverage for Low-Income Children


NEW YORK, Nov. 11 /PRNewswire-USNewswire/ -- Children's Health Fund (CHF), a national organization that advocates for and provides clinical care to disadvantaged and medically underserved children, today issued a Report Card that graded the child health provisions in the Congressional Health Reform bill that was passed in the House of Representatives on November 7.

"CHF applauds the House of Representatives on producing this historic health reform bill which will provide tens of millions of currently uninsured Americans access to secure health insurance coverage," said Caroline DeRosa, Senior Director for Policy & Advocacy for CHF. "However, there is more that must be done to protect and expand health care for children. As health reform continues to be deliberated in the Senate - and then back to the full Congress - we urge lawmakers to revisit the provisions of the bill that deal with coverage and access for children. We want lawmakers to ensure that the hard-won gains accomplished by 12 years of the CHIP program do not get weakened as the legislation makes its way to the President's desk. As the ratings in the CHF Report Card point out, we remain concerned about overall affordability of health care coverage for low income families in general, and the integrity of the CHIP programs in particular."

CHF asked six questions of the bill and responded with a grading system from A to F. The highest grade issued was an A-minus; to the bill's provision mandating health insurance coverage for all children; CHF found that the mandate is estimated to cover 96% of the population.

The lowest, given twice, was a C-minus; these grades addressed the issue of access to care for children; due to the lack of affordability that raises the risk of people forgoing coverage. In addition there is concern about a major government safety net, CHIP. The bill in its current form does not provide sufficient safeguards ensuring that coverage for children currently on CHIP will be as good or better under the new proposal.

The Report Card was graded by asking six questions of the bill:

1. Does the proposal require that all children have coverage?

CHF Grade: A-

2. Does the proposal provide comprehensive coverage for children?

CHF Grade: B-

3. Does the proposal provide affordable coverage for children?

CHF Grade: C-

4. Will all children currently enrolled in or eligible for the Children's Health Insurance Program (CHIP) and Medicaid have the same or better coverage?

CHF Grade: C-

5. Does the proposal expand and strengthen the pediatric workforce?

CHF Grade: B-

6. Does the proposal sufficiently reimburse providers for the care of children?

CHF Grade: B

Comprehensive care received a B-minus grade due to a lack of mandate for early and periodic screening, diagnosis and treatment, the standard of care for children for which CHF advocates. The bill takes positive steps to expand and strengthen the pediatric work force through new grant programs for physicians as well as medical students, for which there exists a dearth of care providers in both rural and urban areas around the country. More needs to be done in this area and therefore a B-minus was given.

Lastly, the bill proposes to increase Medicaid reimbursement rates for primary care services to 100% parity with Medicare rates and then 90% in 2015 and going forward. The provision receives a B as lower payment rates can result in fewer doctors accepting Medicaid patients.

The Children's Health Fund (CHF), founded in 1987 by pediatrician Irwin Redlener and singer-song-writer Paul Simon, is the nation's leading pediatric provider of mobile-based health care for homeless and low-income children and their families. CHF's mission is to bring health care directly to those in need through the development and support of innovative medical programs, response to public health crises, and the promotion of guaranteed access to health care for all children. Teams of dedicated medical professionals in CHF's 24 pediatric programs in 15 states and the District of Columbia have brought essential primary care services through more than 2 million patient visits.

SOURCE Children's Health Fund

SOURCE Children's Health Fund
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