What’s at Stake for Kids and Families if Health Reform Fails? – Say Ahhh! A Children’s Health Policy Blog

Like everyone else in D.C. health policy circles, I’ve
spent much of the last few days obsessively checking for updates on whether
there is a coherent plan emerging from the White House and Congress for moving
forward on health reform. Not yet,
which means that instead of rolling up my sleeves and thinking about how CCF
might best help to implement health care reform, I have some time to
contemplate all that would be lost if policymakers fail to move forward on
reform or decide to scale it back.

The worst thought is giving up on the opportunity to
create a more compassionate and fair health care system.If reform passes, we can expect
millions of children to gain coverage as their parents come forward to apply
for insurance. These children no
longer will go untreated for medical conditions that could affect their
trajectory in life.As
importantly, if reform passes, children no longer would have to see their
parents and other adults in their lives struggling with the untreated medical
conditions or the medical debt that can come with being uninsured.  As my colleague, Martha Heberlein, has
pointed out,
the research is unequivocal on the
point that children fare better when their parents also have insurance,
presumably due to both the financial stability it confers and because it is
tough to be an effective parent when coping with an untreated medical

More immediately, the failure to pass reform would mean
that children could still be denied coverage because they have a pre-existing
coverage, such as asthma, diabetes, or autism. And, we wouldn’t get the benefit of improvements to benefits
for children contained in both reform bills, which means millions of children
could miss out on hearing tests, eye tests, dental care, and, in more serious
cases, developmental assessments that could dramatically affect their ability
to grow and develop.

Finally, reform holds out the tantalizing prospect of
stabilizing and strengthening the successful Medicaid and Children’s Health
Insurance Program, which together cover close to one in three of America’s
children. Medicaid is slated to
receive a major investment of federal funds for extending coverage to more
people, and, also, possibly, for increasing access by improving Medicaid
reimbursement rates. If reform fails, we not only lose a valuable chance to
stabilize and strengthen these programs, but face the prospect of states
cutting back on Medicaid when fiscal relief runs out at the end of this year.
We could see more states try to solve their state fiscal problems, in part, by
putting uninsured children on waiting lists for coverage, as already has
occurred in Tennessee and Arizona.

There has been a lot of rumbling about a scaled-back version
taking on the necessary insurance reforms such as prohibiting insurance
companies from denying coverage due to pre-existing conditions, but this isn’t
a viable option. Many have pointed
that those reforms will actually increase
insurance policy costs if we don’t also expand those who are insured by making
insurance coverage more affordable. If it were possible to ban pre-existing conditions without having the
harder debate about broader health reform, it likely would have happened long

I’m still optimistic that the nation’s policymakers will
find a way to move forward on health reform that offers pathways to affordable
coverage for everyone. The cost of
failing to do so is simply too high.

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