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Another Campaign to Cover the Uninsured, But with a Focus on Kids

By John Reichard, CQ HealthBeat Editor

July 11, 2006 -- A coalition of 38 religious, provider, consumer, and other groups announced a new campaign Tuesday to build a national movement for covering the nation's uninsured children.

The effort by the liberal advocacy group Families USA, the Catholic Health Association, the Presbyterian Church, labor, education, provider, and other organizations aims to cover all of the nation's nine million uninsured children. But it also can be seen as an effort to ensure that current coverage levels do not diminish with the reauthorization next year of the State Children's Health Insurance Program (SCHIP).

Speakers at a noon press conference announcing the Campaign for Children's Health Care were not talking about simply staying put coverage wise, however. "There is no valid excuse for not covering children," said Sister Carol Keehan, chief executive officer of the Catholic Health Association (CHA).

"I've had it," said another speaker, Dr. Georges C. Benjamin, executive director of the American Public Health Association. "Enough's enough. The movement starts today."

"Covering all of our children should not be an option, it should be a given," said Dr. Matthew Levy, a Washington, D.C., pediatrician who spoke on behalf of the American Academy of Pediatrics. "Uninsured children fail to get medical, mental health, and dental services, go without prescriptions, and skip doctor visits, all of which leads to poor health," Levy said.

Even children enrolled in SCHIP or Medicaid cycle in and out of coverage, forcing them to switch doctors and leading to problems such as loss of medical records, speakers said. "The system isn't really a system, it's just fragmented care," Levy said.

Antonia Cortese, executive vice president of the American Federation of Teachers, said lack of coverage is at odds with the Bush administration's No Child Left Behind goals in education. "If children are absent because they can't get the care they need, then we're leaving children behind," she said.

"Children with untreated health conditions have more trouble concentrating in class and have higher absenteeism than children with access to good health care," she added. These problems are "magnified by the fact that there are fewer and fewer school nurses. Unfortunately, school nurses are considered a luxury, not a necessity, in these tight budget times."

Keehan cited results from a CHA survey earlier this month of 800 likely voters showing most Americans aren't aware how many children are uninsured.

She said only 13 percent named children when asked "if you were going to describe uninsured Americans, which one or two . . . groups would come to mind first." Other than children, the groups those polled were asked to choose among included the elderly, working families, and people with low incomes. According to the campaign, one of every eight Americans below age 19 is uninsured, and one of every five uninsured Americans is below that age.

"One of the main obstacles to addressing this issue is a lack of awareness," Keehan said. "Americans want this problem solved when they find out about it," she said. Eighty percent of those polled said they would be willing to pay higher taxes to help pay for coverage of uninsured children.

Sponsors offered no specific estimate of funding for the campaign. "The very diverse coalition of dozens of organizations will be offering many of their resources to support campaign efforts and initiatives," said Families USA spokesman David Lemmon.

The Robert Wood Johnson Foundation has funded a campaign for a number of years to build public awareness of the lack of coverage in the United States, but Lemmon said the problem of uninsured children is particularly timely given that SCHIP reauthorization will be a top congressional health care priority next year.

"The expiration of the SCHIP program gives us a golden opportunity to enact a permanent program guaranteeing that no American child will ever be without health care insurance," said Bill Vaughan, a senior policy analyst at consumer advocacy group Consumers Union.

But maintaining current levels of coverage in SCHIP—about four million children are enrolled—is growing more expensive every year, Families USA Executive Director Ron Pollack said in a response to a question at the briefing. He noted an estimate by the Center on Budget and Policy Priorities that if Congress freezes SCHIP funding in fiscal years 2008–2012 at the fiscal 2007 level of $5.04 billion per year when it reauthorizes the program next year, the shortfall in funding care for four million enrollees would total $10 billion to $12 billion over the five years.

Covering nine more million uninsured children would be a tall order costing many more billions than that. The campaign hopes that an online petition drive on its Web site will help build the needed support and said it also plans town hall meetings and other grassroots events around the country to build support. "This is just the beginning of the campaign," Lemmon said. "We're going to have many more people join over time."

Benjamin emphasized that there are major costs involved in not covering children. The resulting failure to get care or to postpone treatment leads to costly emergency department visits, expensive disabilities, and in the case of untreated mental illness, the expense of imprisonment, he said.

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