Nurses understand in the most fundamental ways the fragility of our children’s health. From the common cold to life-threatening diseases, from immunizations to routine screenings, nurses are on the front lines helping to keep our children healthy and identifying when they are in harm’s way. Our firsthand experience tells us that our nation can ill afford to put our children’s health coverage at risk. But for months, some in Washington who were misinformed or who had the worst intentions did just that by threatening to terminate funding for the Children’s Health Insurance Program, known as CHIP.
For families who earn too much to qualify for Medicaid but not enough for private health insurance, nothing is quite as essential to their children’s health as CHIP. Without CHIP, nearly 9 million children in the United States, from newborns to 19-year-olds, would stand to lose access to even routine doctor visits. Children with specialized healthcare needs are particularly vulnerable because CHIP covers many services that private insurers do not.
Access to care
The benefits of CHIP are incontestable.
Since CHIP’s passage 20 years ago, the rate of uninsured children has fallen from 14 percent to below 5 percent.
For those children enrolled in CHIP, this means access to medical services ranging from well-child visits to dental care to screenings for hearing and vision.
And there’s an added benefit for families transitioning off Medicaid. CHIP keeps them from losing their modest income gains to the high cost of health insurance. “In almost every state, children in families with income up to 200 percent of the federal poverty level ($48,500 per year for a family of four) are covered,” according to the U.S. Department of Health and Human Services.
Because of CHIP, more children now have the opportunity to reach their potential. Children enrolled in CHIP for more than a year in Kansas missed fewer school days due to sickness or injury, one study found. According to the Henry J. Kaiser Family Foundation, “There is evidence that improved health among children with Medicaid and CHIP translates into gains in school performance and educational attainment over the longer term, with potentially positive implications for both individual economic well-being and productivity in the overall economy.”
So how did federal money for this vital program come to be at risk, leaving millions of children in danger of losing their healthcare?
In 2017, Congress, which shares responsibility for funding CHIP with the states, allowed its allocated share of the money to lapse for an unprecedented 114 days. Without funding from Washington, states were left scrambling to avoid freezing enrollment or shuttering their programs for good. The situation worsened on January 20, 2018, when forces in Congress that give CHIP little to no priority undercut any agreement on short-term spending. This triggered a government shutdown that further threatened federal dollars for CHIP. The Senate vote ended the shutdown but, had it continued, the federal government could not have guaranteed its share of funding for CHIP.
No longer at risk
The stakes could not have been higher. But for the time being, at least, CHIP has been reauthorized for six years. Now and for the foreseeable future, the children across the country who depend on this critical program will no longer be at risk. Still, the government shutdown is a reminder of just how fragile our institutions can be, even those that reflect our most deeply held values, like protecting our children.
Hold leaders accountable
Case in point: the Deferred Action for Childhood Arrivals (DACA) program is not a part of the deal that Congress reached. DACA permits children born in the U.S. to remain here and is yet another critical commitment to America’s youth that is under attack. As this column goes to print, debate on this program continues with some vacillation.
A “free and open debate” and good-faith negotiations on DACA have been promised for the upcoming weeks. But with repeated attempts to destroy the Affordable Care Act and with DACA discussions having been at an impasse for years now, it’s hard not to be skeptical. We, as nurses, recognize that it is more important than ever to hold our leaders accountable for their promises to protect DACA.
The children of our country depend on it.
Our children should never fall victim to political polarization. If anything, protecting the next generation should be the one thing that keeps our country united.
