Continuing health coverage programs for children in need is a sound investment in Maine’s economic future and in Maine’s people.
Since the enactment of the federal Children’s Health Insurance Program, or CHIP, in 1997, the rate of uninsured children in Maine has been cut by more than half — from 13 to 6 percent. CHIP provides children with access to quality, affordable health care and gives their families peace of mind about their health and financial security.
Federal funding for CHIP is set to end in September of 2015. If Congress fails to act, this affordable and comprehensive health insurance for our children will end and an estimated 2 million will lose coverage nationwide.
In Maine, low-income children gain access to health care through Medicaid and CHIP. MaineCare — Maine’s Medicaid/CHIP program — has become a vital part of the insurance landscape, covering children up to 213 percent of the federal poverty level, or $42,152 for a family of three. MaineCare also covers children with severe disabilities who would otherwise be institutionalized, children in foster care and those receiving an adoption subsidy. In 2013, the CHIP program provided more than 25,000 Maine children with critical health care coverage. Without this coverage, many families would be driven into medical debt.
Despite this success, Maine’s repeated refusal to accept additional Medicaid funds under the Affordable Care Act has only made it harder to close the insurance gap, which would involve reaching the parents and the 15,000 Maine children who still lack health insurance. Maine and New Jersey were the only two states in the U.S. in the last few years to see an increase in the uninsured rate. We can’t afford to accept this backslide for Maine kids and families, especially when we have achieved an insurance rate for Maine children of 94 percent with the help of Medicaid and CHIP.
Access to affordable coverage for kids isn’t just important for families; it is necessary for economic stability. Children with insurance are more likely to have a stable source of health care and have access to preventive care. Research demonstrates uninsured children are more likely to go without needed care and to experience worse health outcomes than children with coverage, which drives up health care costs. Investing in kids now will more than pay off in the long run.
Some folks wonder, now that we have the Affordable Care Act, do we still need CHIP? The answer is yes. The new health care law is designed to work in partnership with CHIP and Medicaid, not to replace them. If CHIP is not funded next year, children covered under the program might be able to get coverage through their family’s employer-sponsored insurance plan or by purchasing a plan on the federal exchange. But these options are likely to be unaffordable for many families that rely on CHIP, leaving children uninsured.
According to a report on CHIP, which contrasts exchange plans in 35 states, CHIP families would see up to a tenfold increase in their cost-sharing if they needed to transition to one of these private plans. In Maine, the average out-of-pocket costs would increase from $0 under CHIP to $411-$480 under a private plan for a Maine family at 160 percent of the federal poverty level, or $31,664 a year for a family of three.
Even if families are able to afford coverage through the exchange, these plans and systems are designed largely with adults in mind and are not designed to meet the specific health care needs of children. Maine’s CHIP is designed specifically for children and includes pediatric-specific benefits and networks. Maine’s children deserve to be healthy, now and into the future, which is why CHIP’s affordable, comprehensive, child-specific coverage is so important.
On Sept. 6, we participated in the state’s first ever Children’s Convention to talk about the key economic issues facing Maine children and families. At the convention, a Platform for Maine’s Children was released that provides a vision for how to close the gap between what we have and what we need for optimal childhood health in the state. One of the top priorities is to renew children’s funding for CHIP.
CHIP has a long history of bipartisan support, here in Maine and across the nation. It has been successful in providing affordable and comprehensive coverage for millions of children. We call on our congressional delegation to take the lead by pledging their legislative support to extend and improve CHIP. Maine will lead all children into a productive future when CHIP funding is reauthorized.
Claire Berkowitz is executive director of the Maine Children’s Alliance. Dr. Janice L. Pelletier is president of the Maine Chapter of the American Academy of Pediatrics. She is also head of Pediatric Dermatology at Eastern Maine Medical Center in Bangor.