July 14, 2009

Dear Senator/Representative:

Over the last decade, we have made huge gains for children because of the success of the Children’s Health Insurance Program (CHIP) and Medicaid, which serve as the cornerstone of coverage for one-third of our nation’s children. President Obama’s decision to make children’s coverage a top priority by reauthorizing CHIP on February 4th, 2009 was a critical step forward for kids. With your leadership, health reform can build on this progress and finish the job of covering all children.

For health care reform to be viewed as a success, it must ensure that everyone has access to high-quality, affordable care—that includes the millions of children who remain uninsured or who can’t get the services they need, despite having an insurance card. Despite recent gains, millions of children remain uninsured because they cannot afford coverage or because their families face red-tape barriers when attempting to sign them up. As we move forward on health reform, it is important to keep in mind a central tenet of reform articulated by President Obama at a recent talk in Chicago, Illinois: "My view is health care reform should be guided by a simple principle: Fix what's broken and build on what works. And that's what we intend to do." With this goal in mind, we respectfully ask for your consideration of the following four principles:

• Do No Harm to Children. Health reform should not turn back the clock on the progress our nation has achieved for children's health coverage. One-third of our nation's children receive their health care through Medicaid and CHIP. Before moving children out of these successful programs, Congress should ensure that children will receive comparable or better benefits, cost-sharing protections, and access to care under any new and untested program. Congress must ensure that children do not lose the benefits and cost-sharing protections they already have under Medicaid and CHIP. If we fail to protect children, we will spend $1 trillion over ten years but leave roughly 10 million children worse off.
• Preserve Medicaid. Medicaid offers a broad benefits package which includes Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services, an expansive definition of “medical necessity” that promotes children’s healthy development, interpretation and translation services, and targeted case management. By providing these services, as well as other guarantee and accountability provisions, Medicaid and CHIP go beyond commercial plans in meeting the unique needs of low-income children and children with special health needs.
• Insure All Children. Six million children are eligible but not enrolled in public health coverage. Eliminating red tape and bureaucracy by simplifying enrollment would be the cheapest, quickest and smartest first step toward ensuring that the lowest-income kids are covered. Parents should have a hassle-free way to secure coverage for their children through a “No Wrong Door” system that links them to Medicaid, CHIP, or another insurance program, depending on their eligibility criteria.
• Cover Kids from Head to Toe. All children need coverage that meets their unique developmental needs, and provides them with the preventive services, medical care, and oral and mental health benefits needed to launch them on a better trajectory in life. Access to the right care at the right time is an essential element of system reform, and we urge you to ensure that limits on benefits or high cost-sharing will not create barriers to care that children need for healthy development.

We look forward to working with you to build upon the strengths of children’s current health care coverage and to make needed reforms to improve quality, access, and affordability of care for children. There are no do-overs for childhood. We must get health reform right the first time by enacting legislation that improves coverage for America’s children.

Sincerely,

First Focus