65% of all uninsured children have at least one parent working full-time over the course of the year. That simply shouldn’t be the case.

Currently 11 million children in America are not getting the health care they need:

• 1 out of every 4 children is not fully up to date on basic immunizations;
• Half of all uninsured children have not had a well child visit in the past year;
• 1 out of every 3 children with chronic asthma do not get a prescription for medications they need;
• 1 in 5 has trouble accessing needed care; and
• 1 in 3 went without health insurance for all or part of 2002 and 2003.

The bill focuses on three main areas: how to get states to expand coverage; how to get parents to share in the responsibility of covering their children; and how to eliminate enrollment barriers that prevent eligible children from signing up for coverage.

Why expand coverage through Medicaid and SCHIP?

Medicaid and SCHIP provide a crucial safety net for 30 million children. While the number of children living in poverty increased by two million between 2000 and 2003, the number of uninsured children fell thanks to Medicaid and SCHIP enrollments.

Medicaid and SCHIP have a track record of improving the health of children. Studies have found that publicly-insured children are more likely to obtain medical care, preventive care and dental care than similar low-income children who are privately insured. In addition, expanding SCHIP and Medicaid to more children is projected to reduce rates of avoidable hospitalizations by 22%. Children enrolled in public insurance programs were also found to have a 68% improvement in measures of school performance.

According to a recent survey conducted by the Kaiser Family Foundation and the Harvard School of Public Health, 80% of Americans say they favor expanding state programs like Medicaid as a way to increase the number of insured Americans.

State Fiscal Relief and Coverage Expansions

At the center of this proposal is a new plan to offer states fiscal relief in exchange for expanding coverage to more children.

States are experiencing record budget deficits and pressures to cut back on health care for children and the poor. KidsFirst offers states a different path: the federal government will provide significant fiscal relief to the states in exchange for their commitment to expand state health coverage to more children and to help aggressively find and enroll them into these programs.

Under the Kerry plan, the federal government pays for all Medicaid outreach and coverage costs for children under age 21 with family incomes at or below poverty level ($15,670 annual income for a family of three).

In exchange, the state agrees to cover children under age 21 with incomes at or below 300% of poverty ($47,010 annual income for a family of three) through SCHIP or Medicaid. This will cover more than 11 million children who are currently uninsured.

It is in states’ economic interest to participate. There are 20 million children enrolled in Medicaid today, for whom the states pay on average half the costs of care. Under KidsFirst, the states would pay nothing for those children below poverty, resulting in more than $10 billion in savings to states every year. In addition, the federal government will continue to pay the enhanced SCHIP matching rate, so it will still only cost states an average of 36 cents on the dollar to pay for the proposed coverage expansions.

Costs

According to an analysis performed by Kenneth Thorpe, Ph.D. at Emory University’s Rollins School of Public Health, the 5-year federal score for the bill is slightly over $100 billion with a 10-year score of $264 billion. These cost calculations do not include long-term savings to the health care system from reduced reliance on uncompensated care for uninsured children.

Encouraging Family Responsibility

This bill requires parents to insure all children under age 19 and requires proof of coverage to avoid losing their federal child tax credit. Any forfeited child tax credits would finance automatic enrollment into the SCHIP program. It also sets forth meaningful policy changes to help families achieve this coverage mandate by:

• Allowing higher-income parents the right to buy into the SCHIP program for their children at cost;
• Allowing parents to use the SCHIP subsidy to purchase qualified employer-sponsored coverage; and
• Providing tax credits to higher-income parents to make coverage affordable. Parents will not be required to spend more than 5% of their adjusted gross income on health care premiums for their children under age 19.
• 1 in 5 has trouble accessing needed care; and
• 1 in 3 went without health insurance for all or part of 2002 and 2003.

Eliminating Barriers and Expanding Access

In addition to expanding eligibility, there are programmatic barriers that must be removed in order for all children to have access to comprehensive, affordable health care.

Under this bill, states are required to make enrollment simpler, automatic and continuous. Nearly 6.8 million children are eligible for Medicaid or SCHIP coverage but are currently uninsured. Studies indicate that as many as 67% of children who were eligible but not enrolled for SCHIP had applied for coverage but were denied due to procedural issues. The Kerry plan will change that.

To save money during tight economic times, states have done everything from cutting outreach and enrollment funds to keep the rolls down, to actually freezing enrollment in SCHIP. They have implemented eligibility cut-backs, required families to re-enroll on a repeated basis, and instituted higher co-payments and premiums as a deterrent to enrollment.

Making Children’s Health Care a Priority

Senator Kerry has long been passionate about ensuring every child in America has access to health care, and providing health insurance for every child in America is his major domestic priority.

Senator Kerry was there at the beginning of the fight to provide the largest investment in children’s health care since the creation of Medicaid. His 1996 bill, the “Healthy Children, Family Assistance Health Insurance Program,” was the precursor to the successful SCHIP program, which became law in 1997 and provides funding to cover 5 million children.

Now, he is tapping into his large national base of supporters to generate support for children’s health care. In fact, Senator Kerry chose his first e-mail message to his on-line list of nearly 3 million supporters to be about the KidsFirst Act and his plan to provide health care coverage to every child in America.

Senator Kerry is making it clear that he is committed to fighting for this, and he will hold congressional Republicans accountable for inaction or delay. He will push for hearings on his bill in the Finance Committee. He will force a debate in the Senate at every major opportunity. And he will attach the KidsFirst Act to any moving target, giving the Republicans a simple choice – make progress on children’s health care, or show they have other priorities.

Endorsements

KidsFirst has been endorsed by several leading organizations, including:

American Academy of Pediatrics American Federation of Labor - Congress of Industrialized Organizations (AFL-CIO) American Federation of State, County, and Municipal Employees (AFSCME) American Federation of Teachers Americans for Health Care American Public Health Association Every Child Matters Families USA March of Dimes National Association of Children’s Hospitals National Association of Community Health Centers National Association of Public Hospitals and Health Systems Small Business Service Bureau, Inc. Service Employees International Union (SEIU) United Auto Workers (UAW)