Instead of thanking him for noticing something related to my work life and smoothly moving onto our six o’clock scramble routine, I launched into a lecture about how it is a great bill, but we’re not even close to covering 11 million kids. The poor guy…he already has withstood close to three years of near-nightly discussions of CHIP allotment formulas, etc., and in that moment he must have realized that they weren’t about to end just because President Obama signed the Children’s Health Insurance bill into law on February 4, 2009.
Now, I am as thrilled as anyone about the opportunities created by this bill to cover more of America’s uninsured children. But, the flyer congratulating our Senator for getting 11 million kids covered struck me as akin to giving a lifetime parenting achievement award to someone who has just finished delivering her first baby. Of course it was an extraordinary effort to get the CHIP bill through Congress, but things are just getting started!
The reality is that the recently signed CHIP bill gives states a fantastic series of options to use to cover more of America’s uninsured children through CHIP and its larger companion program, Medicaid. But, the success of the CHIP bill will depend entirely on the extent to which states, nearly all of which are consumed by fiscal turmoil, take up the new options and move forward to cover more of America’s uninsured children.
The early signs are promising. Despite the rough economy, many state leaders appear to be holding up their commitment to cover children. The Governor of Arkansas recently signed legislation to expand coverage up to 250% of the federal poverty level and Washington used the passage of CHIP to move forward with an already-planned expansion of coverage for uninsured children.
But, there is much work to be done to make sure that this bill works. With most of the provisions of the new law having just gone into effect on April 1, 2009, it is time to get started. Here is my list of top 3 items to consider:
- Launch a campaign to be one of the best states in the country at reaching already-eligible uninsured children. More than 6 out of 9 million uninsured children in this country are already eligible for Medicaid or CHIP. They aren’t enrolled because their families don’t know about coverage or they have tried to apply and faced unnecessary red tape. The new law includes performance-based incentives for states to find and enroll these uninsured kids in coverage, as well as new tools for reaching them. Even without a new expansion, states can make a world of difference in covering kids by jumping on this opportunity and competing to be the best in insuring already-eligible kids.
- Get rid of the 5-year waiting period imposed on legal immigrant children and pregnant women. For over a decade, states have been forced to impose a federally mandated 5-year waiting period on new legal immigrant children and pregnant women who otherwise qualify for CHIP or Medicaid. In the new law, Congress finally acknowledged that it simply doesn’t make sense to force states to wait five years to cover such children (much less a pregnant woman!). For a child, 5 years is a lifetime and lack of medical care can result in missing the chance to address issues such as autism, asthma, etc. with serious and permanent consequences.
- Make the case that insuring kids is more important now than ever. It is a tough environment in which to persuade policymakers to spend more on anything, but now is the time to remind policymakers that as difficult a time as it is for states to balance budgets, it is an even more difficult time for low- and moderate-income families facing the job loss and home foreclosures. The federal government has stepped in with a significant infusion of money to make it possible for states to provide these families with the peace of mind that goes with knowing that at least their kids can get health care, and states should do all they can to make it happen.