Keep funding for kids’ medical care

It has been 20 years since I’ve had to tell a mother she had no options for insuring her child.

At the time, I had been treating a little boy who was born prematurely and required developmental therapies. He toddled over to me from across the waiting room, shouting my name to show that he could. But his mother had found a new job at her aunt’s hair salon, making her no longer eligible for Medicaid. We were forced to turn them away.

That was my second year of pediatric residency at the Children’s Hospital of Philadelphia. I quickly learned, during this time. that families who made too much money to qualify for Medicaid, but were unable to obtain private insurance, often had no access to medical care for their children.

But that changed in 1997, when Congress created the Children’s Health Insurance Program — CHIP — which provides comprehensive, affordable health insurance for children of low-income families not covered by Medicaid. Quite suddenly, I could care for practically every child who walked through the door.

Unfortunately, funding for CHIP is set to expire in September and requires an act of Congress to be extended. States across the nation are drawing dangerously close to exhausting their federal CHIP funds, placing millions of children at risk of losing this vital resource. The Affordable Care Act — also called “Obamacare” — is thankfully safe for now. But while Congress and the rest of the nation has been consumed by the recent health care debate, little attention has been paid to this looming deadline.

CHIP covers more than 8 million children. Since its implementation, the percentage of uninsured children in this country has fallen from 14 percent to 5 percent. Children enrolled in CHIP have improved access to primary care, dental care and coverage for services such as audiology and hearing aids.

Together, CHIP and Medicaid provide health insurance coverage to 39 percent of our nation’s children. CHIP and Medicaid cover crucial services for children living with disabilities. CHIP and Medicaid insure more than half of children of color, thereby significantly reducing racial and ethnic health disparities. In addition, these two programs have been shown not only to improve health outcomes but also longterm educational performance and economic stability, both of which I have witnessed firsthand during 22 years of personal experience caring for many thousands of Philadelphia’s economically disadvantaged families.

Every day, I see patients in my practice who stand to lose their health care if Congress does not act to extend CHIP funding.

Consider my patient who grew up in foster care, put herself through college and now earns a living as a freelance clothing designer. She is now a mother herself, and I treat her children. Her 1-year-old son has asthma and her 3-year-old daughter has a peanut allergy. They are able to follow up with me every three months and keep a ready supply of lifesaving medications because they qualify for CHIP.

Or consider the dad with a hearing impairment whose wife passed away two years ago. He supports his teenage daughters by working as a line cook during the day and a parking attendant at night. He sends the girls to a parochial school. He lost Medicaid when he was given extra hours at his restaurant last year. But I still see them because they qualify for CHIP.

Health care expenses have soared out of control in our country, and we need good solutions to rein them in. But children are the least expensive age group to cover, and numerous studies have shown that uninsured children only increase economic health expenditures in the long run.

Those of us on the front lines of medicine who care for children and families with limited resources remember well the time that we turned children away solely because their families were working hard to raise themselves out of poverty. Continuity and stability of care for children is more important than ever.

Congress must act now to extend funding for CHIP for the well-being of my patients and millions of other children in our nation.

Dr. Dorothy R. Novick is a pediatrician at Children’s Hospital of Philadelphia. She wrote this commentary for The Washington Post.