KENNEDY ON THE IMPACT OF THE CHILDREN’S HEALTH INSURANCE PROGRAM

(As Prepared for Delivery) Many of the best ideas in public policy are the simplest. The Children’s Health InsuranceProgram is based on one simple and powerful idea – that all children deserve a healthy start inlife, and that no parents should have to worry about whether they can afford to take theirchild to the doctor when the child is sick. CHIP can make the difference between a childstarting life burdened with disease – or a child who is healthy and ready to learn and grow. This need not be a partisan issue. My good friend Senator Hatch and I workedtogether in 1997 to create this program that was our shared vision for healthier future forAmerican children. This year, we have once again worked together to find common ground oncovering the children deserve decent, quality health care. In Massachusetts, in the 1990’s we agreed that health care coverage for children is anecessity and that action needed to be taken. In 1993, the Massachusetts Legislature of thestate’s Children’s Medical Security Plan, which guaranteed quality health care to children infamilies ineligible for Medicaid and unable to afford health insurance. A year later, Massachusetts expanded eligibility for Medicaid, and financed the expansionthrough a tobacco tax – the same approach we used successfully a few years later for CHIPand the same approach that is proposed in the bill before us now.Rhode Island followed and other states took similar action, and helped create a nationwidedemand for action by Congress to address the unmet needs of vast numbers of children forgood health care. In 1997, Congress acted on that call, and the result was CHIP. Senator Hatch and I workedtogether then—as we have this year—to focus on guaranteeing health care to children whoneed it. Now, in every state in America and in Puerto Rico, CHIP covers the services that givechildren a healthier start in life – well child care, vaccinations, doctor visits, emergencyservices, and many others. We know that CHIP works. Children across America depend on it for their health care, butthere are still too many children that are left uninsured.In its first year 1997, CHIP enrolled nearly a million children, and enrollment has grown eversince. An average of 4 million are now covered each month, and 6 million are enrolled eachyear. Every state in America and in Puerto Rico, CHIP covers the services that give children ahealthier start in life – well child care, vaccinations, doctor visits, emergency services, andmany others. As a result, in the past decade, the percentage of uninsured children has dropped from almost23 percent in 1997 to 14 percent today. That reduction is significant, but it’s obviously farfrom enough.Children on CHIP are more likely to have a regular source of care than uninsured children. 97percent of CHIP can see a doctor regularly compared to only 62 percent of uninsured children.What does this mean for these children? It means that their overall quality of life is improvedbecause they can get the care they need when they need it. Their parents are more confidentthat they can get the health care they need, they are more likely to have a real doctor and areal place to obtain care, and, their parents don’t delay seeking care when their child needs it. Children on CHIP also have significantly more access to preventive care.Studies also show that CHIP helps to improve children’s school performance. After just oneyear on CHIP, children pay better attention in class and are more likely to keep up with allschool activities. When children are receiving the health care they need, they do betteracademically, emotionally, physically and socially. CHIP helps create children who will bebetter prepared to contribute to America.CHIP has perhaps had he greatest impact on minority communities. Sadly, we still havepersistent racial and ethnic health disparities in America. African Americans have a lower lifeexpectancy than whites. Many Americans want to believe such disparities don’t exist, butignoring them only contributes more to the widening gap between the haves and have-nots.Minority children are much more likely to suffer from asthma, diabetes, HIV/AIDS and otherdiseases than their white counterparts. Minorities are more likely to be uninsured than whites. More than half of all children whoreceive public health insurance belong to a racial and ethnic minority group. The good news isthat since the beginning of CHIP, the number of uninsured Latino children has decreased bynearly one third and the number of uninsured African American children has decreased byalmost on half. And having CHIP works for minority children. CHIP all but eliminates the distressing racial andethnic health disparities for the minority children who disproportionately depend on it for theircoverage. Minority children are more likely to have their health care needs met. In otherwords they can see the doctor when they need, go to the hospital and get the medicines theyneed just like other children, when they are on CHIP. They are also more likely to have a real doctor –not just sporadic visits to the emergencyroom—when they are covered by CHIP.For specific diseases, like asthma, children on CHIP have much better outcomes than whenthey were uninsured. CHIP’s success is even more impressive and important when we realize that more and moreadults are losing their own insurance coverage, because employers reduce it or drop itentirely. That’s why organizations representing children, or the health care professionals who servethem, agree that preserving and strengthening CHIP is essential to children’s health. TheAmerican Academy of Pediatrics, First Focus, the American Medical Association, the NationalAssociation of Children’s Hospitals and countless other organizations dedicated to children allstrongly support CHIP. A statement by the American Academy of Pediatrics puts it this way--“Enrollment in SCHIP isassociated with improved access, continuity, and quality of care, and a reduction inracial/ethnic disparities. As pediatricians, we see what happens when children don’t receivenecessary health care services such as immunizations and well-child visits. Their overall healthsuffers and expensive emergency room visits increase.” Today, we are here to dedicate ourselves to carrying on the job begun by Congress ten yearsago, and to make sure that the lifeline of CHIP is strengthened and extended to many morechildren. Millions of children now eligible for CHIP or Medicaid are not enrolled in these programs. Of thenine million uninsured children, over two-thirds—more than 6 million – are already eligible forMedicaid or CHIP. These programs are there to help them, but these children are not receivingthat help either because their parents don’t know about the programs, or because of needlessbarriers to enrollment. Think about that number—9 million children in the wealthiest and most powerful nation onearth. 9 million children whose only family doctor is the hospital emergency room. 9 millionchildren at risk of blighted lives and early death because of illnesses that could easily betreated if they have a regular source of medical care. 9 million uninsured children in America isn't just wrong—it's outrageous, and we need tochange it as soon as possible. We know where the Bush Administration stands. The President’s proposal for CHIP doesn’tprovide what’s needed to cover children who are eligible but unenrolled. In fact, thePresident’s proposal is $8 billion less than what’s needed simply to keep children now enrolledin CHIP from losing their current coverage—$8 billion short. To make matters worse, thePresident has threatened to veto the Senate bill which does the job that needs to be done ifwe’re serious about guaranteeing decent health care to children of working families acrossAmerica. We can't rely on the Administration to do what is needed. We in Congress have to step up tothe plate and renew our commitment to CHIP. The Senate bill is a genuine bipartisan compromise. It provides coverage to 4 million children who would otherwise be uninsured. It adjusts the financing structure of CHIP so that states that are covering their children aren’tforced to scramble for additional funds from year to year, and, so that Congress doesn’t haveto pass a new band-aid every year to stop the persistent bleeding under the current program.Importantly, this bill will not allow states to keep their CHIP funds if they aren’t doingsomething to actually cover children. Equally important, this bill allows each state to cover children at income levels that makesense for their state. The bill also supports quality improvement and better outreach and enrollment efforts for theprogram. It’s a scandal that 6 million children today who are eligible for the program are notenrolled in it.In sum, this bill moves us forward together, Republicans and Democrats alike, to guaranteethe children of America the health care they need and deserve. Our priority should be not merely to hold on to the gains of the past, but to see that allchildren have an access to decent coverage. Families with greater means should pay a fairshare of the coverage. But every parent in America should have the opportunity to meet thehealth care needs of their children. In Massachusetts, I met a woman named Dedre Lewis. Her daughter Alexsiana developed aneye disease that if left untreated would make her go blind. Because of our state CHIP programMasshealth, Dedre is able to get the medicine and doctors visits need to prevent Alexsiana’sblindness. Dedre said this: “If I miss a single appointment, I know she could lose her eyesight. If I can't buy hermedication, I know she could lose her eyesight. If I didn't have Masshealth, my daughterwould be blind.” This is the impact CHIP has on families across America. Let me close by saying that quality health for children isn't just an interesting option or a niceidea. It's not just something we wish we could do. It's an obligation. It's something we haveto do. And it’s something we can do today. I look forward to working with my colleagues tomake sure this very important legislation is enacted. List of Organizations Supporting CHIP Reauthorization Act of 20071. AARP2. AFL-CIO3. American Academy of Family Physicians4. American Academy of Physician Assistants5. American Academy of Pediatrics6. American Cancer Society7. American College of Emergency Physicians8. American College of Obstetricians and Gynecologists9. American College of Physicians10. American Federation of State, County and Municipal Employees (AFSCME)11. American Hospital Association12. American Medical Association13. American Network of Community Options and Resources (ANCOR)14. American Public Health Association15. America’s Health Insurance Plans16. Ascension Health17. Catholic Health Association18. Catholic Charities USA19. State of Connecticut, The Honorable Governor Jodi Rell20. Consumers Union21. Families USA22. Federation of American Hospitals23. Fight Crime: Invest in Kids24. First Focus25. Johnson & Johnson26. Lutheran Services in America27. Medicaid Health Plans of America28. Mental Health America29. National Advocacy Center of the Sisters of the Good Sheppard30. National Alliance on Mental Illness31. National Association of Children’s Hospitals32. National Association of Community Health Centers33. National Association of Health Underwriters34. National Governors Association35. National Partnership for Women & Families36. National Women’s Law Center37. Pfizer38. Pharmaceutical Research and Manufacturers of America39. Pico National Network40. Service Employees International Union41. Southern Governors’ Association42. United Jewish Communities43. United Auto Workers Union (UAW)44. United Food & Commercial Workers International Union (UFCW)45. National Education Association46. OMB Watch47. Consortium for Citizens with Disabilities###