This Child Health Care Program Ties the Hands of Parents. Now Is Congress’ Chance to Make a Change.
Meridian Baldacci /
If you’re a parent, you want your child to be healthy. You’ll do whatever it takes to get your child the care he or she needs.
To do that, maybe you sign up for your employer’s insurance plan, or use a health savings account for your family. Or perhaps your child has serious health needs, and you need a specialized plan to get access to the right physicians.
That’s fine—it’s your choice. You’re the parent, and you know what your child needs.
But for 8.9 million low-income children in America, parents aren’t the first decision-makers in health care. For families enrolled in the State Children’s Health Insurance Program, politicians, not parents, choose what coverage is best for the children.
The program was established in 1997 to help uninsured low-income kids gain coverage. And it’s done a good job enrolling low-income children: The percentage of children who are uninsured has been cut in half in the program’s 20 years.
But at the end of September, funding expired for the program. Every few years, program funding must be reauthorized, giving Congress a chance to re-evaluate the program.
If Congress doesn’t act by the end of the year, states will begin to run out of money and may have to cut back their programs. There has been a large push among states to ensure funding continues.
Congress is well aware that this is must-pass legislation. Both the House and Senate currently have bills to refund the program.
Unfortunately, though, refunding is not all that needs to happen to ensure America’s kids get the care they need.
Lawmakers should use this 20-year milestone opportunity to provide structural changes to the State Children’s Health Insurance Program that would improve the range of options that low-income American children have.
While the program has reduced “uninsurance” among children, it has had another effect: enrolling kids in a system that keeps them dependent on the state for their health care. The program provides only limited options for engaging in the broader health care market.
The State Children’s Health Insurance Program is unique in that it gives states some flexibility to decide what type of program they’ll run for children. States receive a certain amount of money, and they can use that to provide a variety of different options.
But in most states, low-income parents are trapped in whatever program their state has chosen to pursue.
If you happen to live in a state that provides you more options—for example, one of the handful of states that will help you pay private insurance premiums—you’re in luck. You might be able to choose between options for your child.
If you live in most states, though, you simply won’t have that kind of flexibility.
Parental choice is more than just a political catchphrase. The choice could make the difference in getting your child the care he or she needs.
While many primary care physicians accept the program’s coverage, there are still gaps. State Children’s Health Insurance Program kids are three times as likely as privately insured children to have difficulty getting a referral to a specialist, and they’re more likely to use the emergency room than their privately insured peers.
Say you’re a low-income single parent with three kids and two jobs. You’re probably grateful that the program covers your kids.
But what happens if your child has a health need that requires a specialist? You might have to make three times as many phone calls as another parent just to get your child the care he or she needs.
Or suppose that you want to pursue alternative health plans for your son or daughter. Maybe you’d rather use a health savings account, or you want to take your child to a doctor that wouldn’t necessarily accept the program’s patients.
Unless your state has a plan that lets you take your Children’s Health Insurance Program dollars there, you’re out of luck.
There’s no reason that a parent should be forced to choose one option for their child just because the state decided that was best. If Congress is spending money on this program to help families, it should at least ensure that low-income parents have choices.
Parents should be able to take the Children’s Health Insurance Program money that the state is already spending, and spend it on options like their employer-sponsored plan, a health savings account, or to help pay for a plan that would focus on specialized options for their child’s unique health needs.
If parents are happy in the state-provided option they have, they should be welcome to use that, too. But they should not be artificially forced to choose a state-run option when there is a plethora of options available to other consumers.
This fall, Congress should put medical decisions in the hands of parents, not politicians.