Policy Pick: Health Care Reform Update

In December, the Senate passed its own version of the bill -- also known as the Patient Protection and Affordable Care Act -- which contains a number of provisions important to young children, including:

• Expansion of Medicaid eligibility to children in families whose household income is at or below 133 percent of the poverty level.
• Creation of a Pregnancy Assistance Fund to assist teen mothers.
• Required coverage for basic pediatric services under all health plans, as well as oral and vision coverage.
• Access to free prevention services.
• A proposal for federal grants to support home visitation programs.
• Extension of the Children's Health Insurance Program (CHIP) until 2019, with funding until 2015.

Children's health advocates like the Children's Health Fund lauded the Senate bill, but point out that it falls short on a number of issues, such as failing to improve reimbursement rates for Medicaid providers and omitting a provision to automatically enroll otherwise uninsured infants. Both changes are included in the House bill.

The fate of the CHIP program also continues to be a source of concern for some advocates. While the program is maintained until 2019 by the Senate bill, the House version proposes to end CHIP by 2014. It will redirect millions of children in the program either to Medicaid or to health insurance exchanges created to facilitate the purchase of private coverage using new federal subsidies to help offset the cost.

According to a recent New York Times article, many House Democrats find it difficult to support a stand-alone health program for children once subsidies are available for entire families. But a number of child health advocates say there are numerous risks in eliminating CHIP. Just shifting children from one program to another could result in some losing coverage, even on a temporary basis. There is also a chance that parents will find coverage unaffordable and choose not to buy it for themselves or their children, even if the coverage is subsidized by the government and despite a mandate in both bills that nearly everyone must obtain coverage.

First 5 LA continues to support health care reform that ensures that all children are physically and emotionally healthy, safe and ready to learn. To read First 5 LA's Statement of Health Care Reform Principles, click here.

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