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Don't Gamble With Our Children's Health

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You simply don't gamble with our children's health. Unfortunately, as the House of Representatives chose to use the Continuing Resolution (CR) as a vehicle for its 42nd effort to defund the Affordable Care Act (ACA) or Obamacare, it "mistakenly" put the health of millions of our nation's children at risk through an amendment offered by Rep. Steve Scalise of Louisiana.

Ironically, although two of the major arguments for defunding or delaying Obamacare is that lawmakers did not fully understand or read the original law passed three years ago and that some people might lose health coverage they currently have, the House indiscriminately sought to defund all spending in the ACA without fully understanding the implications of the language or the fact that millions of children would potentially lose health coverage they currently have through the Children's Health Insurance Program (CHIP) due to the Scalise Amendment.

Shockingly, if passed into law, the House-passed CR would slash $13.3 billion or 70 percent out of CHIP, which provides health insurance coverage to six million children of working families in this country. The Scalise Amendment would effectively kill CHIP just a few days from now -- on October 1.

Although purpose of a Continuing Resolution is to keep the federal government operating, the House bill would do the exact opposite for children by largely discontinuing CHIP and putting the health of millions of children at risk.

From conversations with House staff, it appears this was not the intent. Speaker John Boehner wrote after the vote,

...the House voted to ensure the federal government remains open, continuing to fund basic services essential to millions of Americans, like paying our men and women in uniform, funding veterans' programs, supporting millions of seniors who rely on Social Security and Medicare, and much more.

There is no mention of children, as kids were, yet again, an unfortunate after-thought.

However, the fact is that while "essential services" were protected for most everything else, the health of millions of children (and apparently senior citizens and the disabled on Medicare) were placed of the chopping block.

Unfortunately, rather than fix the potential "unintended" disaster caused by his amendment, Rep. Scalise doubled down and blamed others when he said:

Many longstanding and successful programs were impacted by the Affordable Care Act and we look forward to working with the Senate and the White House to ensure that those programs have a smooth transition as we protect American families from the devastation of the President's train-wreck of a health care law. Programs such as the Children's Health Insurance Program should not be held hostage by the Administration and Congressional Democrats to protect the taxes and mandates in the Affordable Care Act that are raising health costs and killing jobs.

The fact is that, although the future of CHIP was threatened at one point during the consideration of the ACA in 2009, the health reform bill was successfully modified by Sen. Jay Rockefeller to fully fund CHIP through 2015 and authorize it through 2019. Tragically, the Scalise Amendment would effectively reverse and defund the program in just the matter of a few hours.

Rather than kill CHIP, the American people overwhelmingly support its extension. In a 2012 election eve poll by Lake Research Partners, support among voters for extending CHIP was at 83-13 percent, including 86-10 percent among women and 75-21 percent among Republicans.

Americans are looking for solutions and answers to the needs of our nation's children. No one believes that children should be sick, live in pain, or go without preventive care like vaccinations and annual check-ups just because their parents have lost their job or simply can't afford health insurance. They understand that investing in the health of our children is investing in America and its future. When our children develop and thrive, we are paving the way for our country's next generation of workers and leaders. And when our kids aren't healthy, they do not learn and we will fail to stay the world's leader in innovation. That is why CHIP has proven to be so important.

In 1997, in one of those rare moments of bipartisanship, and again in 2009, Republicans and Democrats in the Congress and the President agreed to initially pass what was originally called the State Children's Health Insurance Program (SCHIP) and then reauthorize and extend CHIP to guarantee millions of children of working parents the right to see a doctor and get the health care they need. Over its 16-year history, CHIP, in partnership with Medicaid, has proven to be an enormous success story.

As an example, CHIP has clearly improved access to care and outcomes for millions of our nation's children and is why the American people overwhelmingly support it. As my colleague Lisa Shapiro has written, "CHIP allows children access to pediatric-specific provider networks, and goes above and beyond many private insurance plans in addressing the unique needs of low-income children." Put simply, it works.

In fact, according to the National Academy for State Health Policy (NASHP) in its report entitled Keeping Children's Health Coverage Strong in the Context of the Affordable Care Act: Perspectives from State Children's Health Insurance Leaders:

In 1997, before states began implementing CHIP programs, 23 percent of children at or below 200 percent of the Federal Poverty Level (FPL) were uninsured. By 2010 the rate had fallen to 10 percent, and 85 percent of children eligible for these programs were enrolled.

Unlike the rest of the health care system, CHIP has been developed to specifically address the needs of children. The health plans in CHIP are, by definition, pediatric networks of care with pediatric-specific quality objectives and measures. In short, CHIP recognizes that children are not "little adults" and have their own unique health and developmental needs. And, it works.

Although there are have been some problems or "glitches" with the ACA that we have repeatedly expressed concern about and should be addressed, the health reform bill would build upon the successes of Medicaid and CHIP to further benefit children.

In fact, health care reform holds the promise of improving the health and well-being of children in a number of critically important ways, including the protection of health coverage for children with cancer or other diseases from being denied coverage for pre-existing conditions or because they hit annual or lifetime insurance caps.

Furthermore, as NASHP found:

A 2011 analysis concluded that full implementation of the ACA could reduce the number of uninsured children by 40 percent, as well as the ranks of uninsured parents by 50 percent. However, if support for CHIP and Medicaid coverage for children is not sustained through continued funding for CHIP beyond 2015 and maintenance of Medicaid and CHIP eligibility levels and enrollment policies, the uninsurance rate for children might be higher than it was before the ACA.

This could all be destroyed if the Scalise Amendment were to be adopted or if Sen. Ted Cruz were to be successful in his expressed desire to filibuster the Continuing Resolution until the Senate agrees to "pass [the] House bill as is and demand 60-vote threshold for any effort to add Obamacare funding back into bill."

Incredibly, the problems with the Scalise Amendment are even more far-reaching. According to an analysis of the Scalise Amendment by Department of Health and Human Services' Secretary Kathleen Sebelius:

Federal funding for the Children's Health Insurance Program (CHIP) would end on October 1. States that expanded eligibility under their approved Medicaid state plan for parents and childless adults (the early adoption option) would immediately lose funding for this population, and federal funding would not be available for states that have planned expansions under their state plans as of January 1, 2014. The delivery of health care to medically-underserved people at many community health centers would be reduced due to a nearly 60 percent reduction in federal funding. National Health Service Corps funding would be eliminated. The Health Resources and Services Administration's Maternal, Infant, and Early Childhood Home Visiting program for at-risk children (which encompasses grants to states and Tribal entities) would be eliminated. Over 92,000 individuals in the Pre-Existing Condition Insurance Plan Program would immediately lose coverage. H.J. Res. 59 would also cut funding needed by the HHS Office of Inspector General, the Centers for Medicare & Medicaid Services, and the Department of Justice to fight health care fraud and would take away important anti-fraud tools that were enacted through the Affordable Care Act. H.J. Res. 59 could adversely affect the delivery of health care in Indian Country by undermining the substantial changes the Affordable Care Act made to the Indian Health Care Improvement Act. A funding prohibition would also appear to block federal enforcement of all of the health insurance market reforms enacted in the Affordable Care Act, including the prohibition on pre-existing condition exclusions for children, dependent coverage for young adults under age 26, the prohibition of lifetime limits, and coverage of recommended preventive services without cost sharing.

For the health of our nation's children, it is important to understand that Sen. Cruz is demanding that a 60-vote super-majority be required to restore funding to the Continuing Resolution for both ObamaCare and CHIP and threatening to filibuster and possibly shut down the government unless he gets his way.

While this creates interesting political theater (i.e., filibustering a bill that he actually supports), the health coverage of millions of children might, yet again, become an after-thought and harmed. As a result, we strongly urge the Senate to fully address the needs of children in the CR, reject Sen. Cruz's demands, and instead, restore funding for both the ACA and CHIP so that the negative far-reaching consequences to the health of children are not realized.

Children should never be allowed to be collateral damage in a game of political brinksmanship.

And, it's far past time that we put the health of our nation's children above those of special interests and political theater. You simply don't roll the dice or play political games with our children's health.