A Strong and Affordable Exchange Should be Children’s Priority – Say Ahhh! A Children’s Health Policy Blog

John Bouman

(Editor’s Note: John Bouman is the President of the Shriver Center. He is recognized for being one of the most effective and thoughtful public-benefit advocates in the country. Say Ahhh! asked him for his thoughts on national health reform.)

We all worry about our children so of course we are
concerned about the treatment of children in health reform. There is worry about the House bill’s
ultimate elimination of the CHIP program and switch of covered children into
either Medicaid or “the exchange”. The exchange is said to be
too uncertain, because premiums and co-payments could be too high and result in
families not buying coverage, which could then result in the family’s children
becoming uninsured.

Those are legitimate concerns and worthy of the strong
advocacy they are getting. Children’s advocates have worked hard
to preserve the CHIP program at least until the “exchange” plans
prove themselves as vehicles for children’s coverage. But it is also
important to work to achieve the best possible affordability of insurance in
the exchange. Arguably, it is the higher priority.

The best way for a child to be healthy is for the child
to be part of healthy family. If the parents understand
prevention and early treatment, and pursue their own health, the children are
much more likely to be on that course themselves. For children to
be healthy, they not only need coverage, but they need to be
enrolled, connected to a doctor, and then actually conveyed to the doctor at
the right time by their parents (or other caregivers), which is
much more likely if the parents are healthy and focused on their
own healthcare.

So the top option for a health system, from the
children’s point of view, is a system that serves families well, promptsiStock_000005608156Large.jpg
smart healthcare behavior by the adults, and maximizes family health.
If we can’t have that, then the fallback is a system that at least does
what it can to serve the children. That’s the current U.S. system as it
applies to low and moderate- income families. We fail the parents and
young adults, but we do what we can through Medicaid and CHIP to help the
children and a few adults. Because the system, by failing to cover
adults, blocks most of them from establishing a medical home and pursuing the
smartest health care possible, their children are denied the chance to live in
a healthy family and thus denied the best chance to be healthy themselves.
Because we have a fallback system, recently improved through CHIPRA, the
children still have a chance for a healthy life, but it’s a second best chance.

The best way to achieve children’s health is through
whole family health. Children’s advocates should not leave
advocating for a strong exchange to other health care advocates. A strong
and affordable exchange should be the first priority for children
because it includes the whole family, which is the healthiest situation for
children. The children’s groups should be leaders in support of the
affordability of exchange policies, even as we continue to fight hard to
make sure that CHIP is there for kids who need it.

The views expressed by Guest Bloggers do not necessarily reflect
the views of the Center for Children and Families.

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