Health Reform that Works for Kids

Policymakers must consider the needs of children in any health reform proposal.

SOURCE: AP/Ron Heflin

By Karen Davenport | May 28, 2009

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Read the full memo (CAP Action)

Congress has set the stage for further steps toward providing affordable coverage for all Americans with the reauthorization of the Children’s Health Insurance Program and significant investments in health care infrastructure in the American Recovery and Reinvestment Act in 2009. As the nation’s attention turns to systemic health reform, one challenge will be to ensure that all children enjoy stable, affordable coverage.

Leaders of the push for health reform appear committed to ensuring that all children enjoy the health benefits and enhanced financial security of health coverage. Yet proposals currently under development in Congress will not automatically achieve this goal. Current proposals pay more attention to expanding coverage for uninsured working-age adults than for uninsured children, while delivery system reforms may not necessarily benefit pediatric patients. Congress must ensure that systemic health reforms work for children. Children’s advocates will need to identify and pursue opportunities embedded within health care reform proposals to ensure that all children will have affordable, meaningful coverage that meets their unique needs.

Congress is now weighing new approaches to providing affordable coverage for all Americans. Congressional committees have not yet released initial legislation, but it is already evident from option papers and other materials that the legislation will build on the framework of “shared responsibility,” also embraced by President Barack Obama’s campaign plan. This approach seeks to expand health coverage and reform the health care delivery system through a combination of public insurance program expansions, subsidies for private coverage, restructuring the health insurance market, and investments in delivery system improvements.

How well these reforms will work for children is an open question. Policymakers must carefully consider their choices to ensure that all children can enjoy the benefits of health coverage.

The analysis that follows addresses critical questions, including:

• How to guarantee that children’s coverage is available and affordable for all families.
• Whether private plans’ benefit designs will include services critical to children’s care.
• Whether low-income children can be enrolled in public plans with historically generous benefit packages.
• How to ensure equitable financing that does not ask families to bear a heavier tax or premium burden than other Americans.
• The scope of health system improvements.

Read the full memo (CAP Action)