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Marian Wright Edelman

Marian Wright Edelman

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Celebrating and Protecting Health Reform for Children

Posted: 04/ 2/11 01:01 PM ET

A year ago President Obama signed into law the Patient Protection and Affordable Care Act (the “Affordable Care Act”), guaranteeing access to health coverage for 32 million uninsured people in America including 95 percent of all children. Racial minorities are disproportionately uninsured today and the Affordable Care Act will have a particularly positive impact in communities of color if allowed to go forward.


The first pieces of the Affordable Care Act to take effect have brought critical relief to millions of children and young adults. As implementation of the law proceeds insurers can no longer deny coverage to children with pre-existing conditions, impose annual or lifetime caps on coverage, or revoke coverage when someone gets sick. Insurers must cover preventive services for children without co-payments or cost sharing. Parents can keep children on their insurance until age 26 helping more than 1.2 million young adults as they graduate from school and work. The hundreds of stories in a new book by Moms Rising about how health reform has improved the lives of children and families reflect the many failures that have been fixed. We must continue to move forward.


Yet even as we celebrate health reform, the Affordable Care Act and one of its cornerstones, the Medicaid Program, are under attack. Medicaid is a health lifeline for millions of children and vulnerable people. Opponents of the Affordable Care Act have promised to repeal, roll back, or defund the law and have targeted Medicaid for “reform” that would actually cripple the program and the lives of the children and low income people who depend on it.


Medicaid currently covers close to 60 million people, including many children with disabilities or special health care needs, pregnant women, low income adults, and seniors. Under the Affordable Care Act in 2014 Medicaid will expand to reach 16 million more children, parents, and childless adults with incomes below 133 percent of poverty ($29,400 for a family of four). Medicaid and the Children’s Health Insurance Program (CHIP) together provide health coverage for more than one in three children and more than four in 10 births.


In February, the House of Representatives passed a bill that prohibits funding for implementation of the Affordable Care Act. Next week the House is expected to take up legislation that would allow states to cap spending for Medicaid decimating all current guarantees of coverage. In a further assault on children’s health care, the House is expected to consider legislation to repeal the maintenance of effort provision which prohibits states from cutting back on Medicaid and CHIP coverage for children until 2019.


Failing to invest in children’s health through the Medicaid program will put our nation on exactly the wrong economic track. Research has shown that an uninsured child costs the local community $2,100 more than coverage for a child with Medicaid or CHIP. Sacrificing the health and achievement of the next generation is penny-wise and pound foolish when other nations are pulling ahead and leaving our children behind.


Medicaid has served as an important safety net for hundreds of millions of children in the almost 50 years since it was enacted and played a critical role in keeping children covered during the recent recession. Children constitute more than 50 percent of total Medicaid beneficiaries but only about 20 percent of the program’s cost. The program is efficient, with administrative costs about half that of private insurers, and lower per child costs.


The low cost of covering children compared to the high costs of dealing with the consequences later is a no brainer: efforts to cut children’s coverage by capping federal Medicaid spending, repealing the maintenance of effort provision, or defunding the Affordable Care Act are all shortsighted and would be harmful to our nation’s future economic security. Strengthening our nation financially need not and must not come at the expense of our most vulnerable children’s health; strengthening our nation requires investing in children.

 

Follow Marian Wright Edelman on Twitter: www.twitter.com/ChildDefender

 
 
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04:44 PM on 04/04/2011
Some of these people are in La La land. Of course it sounds wonderful to offer health insurance for all. However, what happens is they sign into law these great sounding ideas without an ounce of research!!! Now many insurers have DROPPED child only policies altogether so how will that help preexisting conditions????? I'll bet Washington didn't consider that did they? There are many loop holes with health care reform that no one has even bothered to investigate for wanting to be the first to sign this bill in to law!

With states being broke and cutting out some medications and procedures for Medicaid, I can only imagine the headaches to come in 2014...
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DMDAY44
08:35 AM on 04/04/2011
The claim that the Affordable care act have given greater access to children for health insurance is a crock. I am an independent insurance agent. What has happened is that the majority of Health Insurance companies companies are no longer offering child-only policies. They can't, otherwise some people would wait until a major illness then buy the coverage. It doesn't take a genius to understand why that won't work. In order to purchase a Major-Medical policy for a child, there has to be at least one adult on the policy also. Furthermore, if a child has major pre-existing conditions, their portion of the premium can be rated-up, sometimes as much as 300%, to help defray the costs of claims. Because of heath care "reform", about half of the policies that were available a year ago are no longer on the market, and the ones that are left are more expensive.

I have been in this business for ten years, and I have yet to see a policy cancelled because someone got sick after they bought the policy. It is not allowed in this state. An insurance company can cancel a policy for one of three reasons: Failure to pay premium, Material misrepresentation of fact on the application, or if they cancel all policies in the State.
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usna73
We are all in this together
09:00 AM on 04/04/2011
1) Policies ARE cancelled after people get sick. That is just a fact. Read Congressional testimony. Just because you haven't seen it doesn't mean it doesn't occur.

2) What do you propose to provide coverage for all children, when in fact insurers can simply "refuse" to underwrite them in many states?
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DMDAY44
09:26 AM on 04/04/2011
With all due respect I would wager that I know more about health insurance and how it works than you do. Policies do get concelled, yes, but in the state I live in you cannot be cancelled because you file a claim. I can't speak for what happens in other states, but if that does happen a simple change in state law can fix it - we don't need a massive federal law nobody has read to do that.

As for coverage for all children, the problem is that people don't understand that insurance is the spreading around of risk - it is not a bill paying service. The state insurance laws here provide that when a child is born or adopted there is a period of time in which that child can be added to an existing policy with no questions asked. I would suggest that we extend that provision so that a person can change from one insurance plan to another - provided the coverage is comparable or less, in order to give people the opportunity to shop prices if they think their coverage is too expensive without having to worry about pre-existing condition exclusions. That is part of the intent of the coverage mandate, but believe it or not I don't think people should be required to purchase health insurance coverage - it is not the place of the Government to tell someone they have to do that.
12:39 PM on 04/04/2011
"Material misrepresentation" can be a forgotten case of acne for christ sake!
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DMDAY44
01:32 PM on 04/04/2011
Not unless you were seeking coverage for the costs of treating severe, chronic acne.
01:50 AM on 04/04/2011
There are a lot of people who believe in social Darwinism, though they decry vehemently the teaching of evolution in public schools. Belief in funding or in denying funds for children's healthcare depends, at least in part, upon one's view of social Darwinism. Those who believe in it are often the same people who demand that religious teachings find their way into school curricula. Actually living out religious teachings, particularly those that reflect Christian values, seems to be much less important. Form over substance. Let poor kids eat cake! But if they get sick, let them and their parents just "suck it up and deal," especially if they are illegal immigrants, who are, in the minds of social Darwinists, the only ones benefitting from the new healthcare law. Besides, everyone knows that God doesn't really want us to tend to the sick, take care of widows and orphans and feed the hungry.

Thank you for the work that you do on behalf of all children, Ms. Edelman!
09:19 PM on 04/03/2011
Then, Marian, get your check book out and care for all the people you can--Just use your own money. Not mine.
09:32 PM on 04/03/2011
It doesn't work like that, she wants your money.
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cwebster
predominantly exasperated
12:12 AM on 04/04/2011
Why so selfish and self-centered? Why not stop funding the wars instead of cutting social programs? Why keep giving money to the rich and corporations?
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Kara Kramer
07:59 PM on 04/03/2011
And these people claim to be prolife.
Democrats need to stop arguing policy with modern republicans and just accept them for what they are, dishonest people running on a platform of selfishness and wickedness.
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samtee
Shankapotomus.
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Tulka2
Solidarity. Courage. Humor.
02:21 PM on 04/03/2011
It's not about the money.  It's not.  It's about a mean-spirit.  It's about race.  I am an old white lady and i say this.  Pull a thread here and it leads right back to the Civil War.  There are many powerful people in this country who think privately the wrong side won.
06:40 PM on 04/03/2011
I see in America a slave master attitude that believes we must keep importing foreign labor. The only people who want to keep importing more labor are thinking about ways to drive down wages for workers.
02:03 PM on 04/03/2011
I don't know how to go about doing it, but if anyone has thoughts, let's hear them.

I would like to propose that until the health care crises/debate is ended and resolved, all members of the House, Senate and Executive Branch give up their Rolls Royce medical coverage and become enrolled as full participating members of Medicaid.

Unfortunately, it would probably take an act of Congress.
12:40 PM on 04/04/2011
Just look at the rest of the civilized world if you are hungry for "ideas".
12:13 PM on 04/03/2011
And wait until the Democrats (or Republicans) grant amnesty a few more times. What will we do then? By law, we have no choice but to give them healthcare once granted amnesty.

And what about free trade? If healthcare costs keep rising then offshoring will just continue. And there isn't anything in the Affordable Care Act that controls costs. Does anyone really think insurance corporations are in the business of controlling costs? They are in the business of maximizing your payments and minimizing your care. And Obama decided he wants the insurnace companies to remain a cornerstone of care.
04:51 PM on 04/04/2011
They could care less. All the political parties want to do is be first at something. If the $88 billion for illegal health care in CA didn't bother them nothing will. People cry, let them come. Ok, and who's going to pick up the cost? Taxpayers are already taxed to the hilt!!! I know people who've been unemployed for 2 yrs.

If anybody approves of illegal immigration, their healthcare costs should be paid for by the family who wants them here and that includes delivery of babies and surgery.
12:08 PM on 04/03/2011
The Affordable Care Act is a mandate to buy privatized insurance from anti-trust exempt corporations with no cost controls. Its like being forced to buy a car from GM; the prices would be as high as you could afford. If the sales person knows you have to buy and the government is subsidizing the prices, and they are legal monopolies (there are 2 legal monopolies in the US and health insurance is one)...then they have every possible incentive to raise prices to take all your available income.
And a subsidy is just a transfer from your taxes to the same sales person.
12:43 PM on 04/04/2011
So how can anyone consider casting another vote for the feckless CHANGE CANDIDATE??
He personally killled the PO and forced the mandate- both things complete flips from his audacious 2008 HOPE campaign.
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Mary Blickhahn
Mary Quite Contrary
10:04 AM on 04/03/2011
How can any politician make a really good choice for our health care when they do not have to use the same systems we do?
letsbepeaceful
oh no, my micro-bio is now full...
01:01 PM on 04/03/2011
They do, actually. The government offers a choice of plans from several insruance companies, and subsidizes them, in the same way that companies subsidize health care for their employees.

The problem is that they can't be denied, the plans are mostly quite high-end, and the coverage can be extended thru life. What would be 'good' would be for these politicians be forced to sign up for individual policies with all the exclusions, limitations, and deductibles (and of course no subsidy) that those policies generally have. Then they might get a better sense of how expensive health insurance (and care) really can be without subsidy. Most of them have pre-existing conditions, I'd bet!
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06:51 PM on 04/03/2011
And, to add to your post, though it's true, lawmakers are subsidized by their "employer," since their "employer," is the government, that is we, the people. I resent having my tax dollars pay for 70% to 75% of their monthly premiums month after month, as they continually deride the Affordable Health Care Act, want to deny reform of any kind that is reasonable and fair for the average person, family, or child.

Anyone with any modicum of sense knows that the voucher system they constantly offer would never begin to pay if something really serious were diagnosed, or a serious accident took place in your life.
01:09 AM on 04/03/2011
Let me tell you one thing that the best health insurance plans has completely different set of meaning for different type of people. For those who are rich, the plan which can earn them more is best. However, those who are in the middle class have different ideas. They think that insurance plan is the best for which they will have to pay minimum premium. However, the poor person does not even know that what is health insurance? If you are one of them search online for "Wise Medical Insurance" and get smart about insurance.
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Mary Blickhahn
Mary Quite Contrary
10:00 AM on 04/03/2011
You know this is really insulting. I am sure it is due to trying to figure out what to say in a few words. I have better attempts then others myself. Here is how I see most working peoples plans..

I pay out one paycheck for health insurance then spend a chunk of the other on co-pays. The family doctor charges me a terrible copay then orders a bunch of work done. I take another series of days off of work to go to the facilities to have blood work done, x-rays and exams. All of which have co-pays themselves . Then I take more time off of work to go back to the doctor to pay another copay to hear what the conclusions are. The time off of work is more lost income and may result in the loss of my job. Mainly because my company refuses to invest in better health care.

Many corps fail to do even that much. They hire employees as temp contractors to avoid providing health benefits at all. As military our health care quality depended on how much the commanding officers felt like working. Some years were better then others! We had better insurance at a lower cost once, but the corp CEO's didn't like paying for it, so it went by by!

As for only the poor needing to learn more about "Wise Medical Insurance" well maybe the education needs to start with you!
letsbepeaceful
oh no, my micro-bio is now full...
01:14 PM on 04/03/2011
I think that what rhonda is trying to say is more like - the rich go for the plan that will pay out the most, without care for their premium, but that many in the middle class think the plan is best if it has lower premiums, not thinking about the deductibles and copays (not sure she's right there, but it's her idea).

And that many of the poor really do not understand how insurance works, so they say 'get government out of my insurance', with no understanding that Medicare and Medicaid are government programs.

Copays and deductibles are insane, sometimes. Unfortunately, without a single payer or the proposed health exchanges, it is probably too expensive for your company to offer a more expensive plan - and no plan will make your concerns about time off from work for tests and whatnot any different. Most medical facilities (except in the largest cities) only do testing during the day, so their workers and technicians can work 9-5 too.

And I agree with you about the temp or contracted worker situation - again, single payer or health exchanges will minimize that.
08:24 PM on 04/02/2011
Medicaid is an insurance program. One that absolutely saves lives through access. While it does not pay providers or hospitals well it is critical and essential to be maintained. It saves the lives of all people, not just children. States, especially New York, are attacking Medicaid and the deaths of patients not having access will clearly be attributable to the callous actions of the new governor Cuomo who is the chief attacker of Medicaid and the poor. Medicaid pays less than 7 dollars a doctor visit in some situations but it is something and there are clinic s who accept it and offer e needed care. The politicians who want to limit this program have no idea of it's value.
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petef59
my micro-bio is empty
08:50 PM on 04/02/2011
The yearly increase in dividends for health insurance stocks, plus all the bonuses, perks, golden retirement packages for insurance company, equipment supplier, pharmaceutical executives, management and salespeople is THE IMPORTANT OUTCOME.
letsbepeaceful
oh no, my micro-bio is now full...
01:25 PM on 04/03/2011
There is a lot of rumor going around about cuts to Medicaid in NY. But the major 'cut' is a limit in spending increases to the previous year's medical inflation rate. I haven't seen anything (and I just researched it) that would indicate any significant reduction in current Medicaid practice.

(As of October 2000, the fees were generally $30 per visit, not $7 - although I remember when they WERE $7 - even so, not a lot of reimbursement, and that's a good reason why so few doctors take Medicaid.)
03:09 AM on 04/04/2011
The cuts are on the hospital side which will have tremendous impact on hospital based clinics and admissions.
03:19 AM on 04/04/2011
According to the New York State website a Medicaid outpatient hospital visit for a new patient pays 6 dollars. An established patient 5 dollars. Seeing a patient in the hospital gets you 6.50. Seeing a patient in the emergency room is similar. The 30 is private practice setting. Most Medicaid patients go to hospital based practices.
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samtee
Shankapotomus.
06:50 PM on 04/02/2011
I see she hasn't read the bill, or doesn't understand it one.
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Romaine Chritton
05:22 PM on 04/02/2011
The Republicans and Tea Party do not care about children, young adults and anyone else that is vulnerable. Not all families can afford health care insurance, and these folks do not consider them worthy to participate in life let alone the American Dream. A very sorry state on so many levels!
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samtee
Shankapotomus.
06:52 PM on 04/02/2011
No all the childern they have at home don't mean anything to them, do you people realize what comes out your mouth, this health care bill is destrucktive to our nation get it.
07:20 PM on 04/02/2011
Samtee

Sensing a lot of anger here. Would like to understand more why you think the health care bill is destructive to the nation.

I have asked politely, and expect a response in kind.
Thanks