1. Children's Health Bid Creates Odd Unions The multimillion-dollar lobbying effort to expand a children's health insurance program is creating some strange bedfellows. Seniors are joining with doctors. Unions with health providers. The pharmaceutical industry with one of its biggest critics, the advocacy group Families USA. They share the same goal--expanding the State Children's Health Insurance Program (CHIP). A bill moving through the Senate would add $35 billion to the program over the next five years, raising total spending to $60 billion. House leaders will likely call for adding $50 billion to the program. The Bush administration has recommended a $5 billion increase. AARP, with its 39 million members, and the American Medical Association, plan to make it uncomfortable for Republican lawmakers to agree with the administration's position. On Friday, the two organizations announced a lobbying campaign that they said will likely exceed $2 million. They back the House legislation for two reasons: It would expand health insurance to more children and eliminate a 10 percent cut in reimbursement rates for doctors who see Medicare patients. The cut would kick in January 1, unless Congress intervenes. The House legislation would pay for those changes by increasing tobacco taxes and lowering payments to insurers who administer health plans for Medicare beneficiaries. The two groups will spend about $1.3 million for an initial wave of television ads that will run nationwide. The groups also will use direct mailings to ask members to meet with lawmakers during the August recess. "This is a substantial effort we're undertaking in order to get this legislation passed," Bill Novelli, the AARP's chief executive officer, said Friday. Just a day earlier, the Partnership for Quality Care, an organization of labor unions and health providers, unveiled an ad in which children, parents and health care providers explain that an increased tobacco tax will not only help more children become insured, but would also decrease smoking. The group was the first to use ads that clearly advocate for a way to pay for CHIP's expansion. Kate Navarro-McKay, spokeswoman for the partnership, said the ads would run in 13 congressional districts - eight Democratic districts and five Republican districts, over two weeks. The cost: $1.2 million. The ads were not designed to pressure lawmakers so much as to appeal for bipartisan leadership on the issue. The 13 were chosen because of their potential to be leaders on the issue, she said. "It's a message of optimism. We're appealing to their angel," Navarro-McKay said. Health insurers will join the lobbying campaign for CHIP by running ads that would support the Senate's call for a tobacco tax increase. They will pay for separate ads designed to dissuade viewers from the approach the House plans to pursue, which is to cut payments to insurers that administer managed care plans under Medicare. That particular program is called Medicare Advantage. "If it's anywhere near the ($50 billion) number that we're hearing it is, it means the end of the Medicare Advantage program," said Karen Ignagni, president and CEO of America's Health Insurance Plans. "That means Congress would be asked to vote on one of the largest Medicare cuts in history." The television ads coming from Families USA and the trade associations it partnered with won't be partisan. They won't favor one legislative chamber's proposal over the others, but they could have political influence nonetheless. "We're trying to influence members of Congress to do the right thing and support the expansion of the CHIP," said Families USA spokesman Dave Lemmon. Also taking part in the alliance with Families USA and the drug manufacturers are trade associations representing doctors, hospitals, and nursing homes. The trade association representing drug manufacturers, the Pharmaceutical Research and Manufacturers of America, has been running television ads for several weeks on cable news shows touting CHIP. The ads ask viewers to tell Congress to support CHIP but don't talk about the size of an expansion. Officials did not disclose the amount spent on the ads. Another organization that has put big dollars into lobbying for the program but won't disclose how much is the Children's Defense Fund. The organization has paid for television ads on CNN and on local television in several states. The organization also has placed print ads in the New York Times and in states where presidential debates are occurring, as well as in move theaters. The Children's Defense Fund has also set up its own web site for a fictional presidential candidate, a young girl named Susie Flynn. The candidate asks people to sign her petition in support of health care for all children. As of Friday, about 20,000 people had signed it. [Kevin Freking, Associated Press, 07/20/07] 2. Pragmatism, Ideology, and Children's Health A commentary by Stan Dorn argues that reauthorization of the State Children's Health Insurance Program (CHIP) has become enmeshed in ideological struggle, rather than practical problem-solving. Reducing the number of uninsured, low-income children by more than a third, CHIP is a block grant program that provides children with private insurance. With neither a federally mandated benefits package nor an individual entitlement, bipartisan CHIP expansion proposals would cover millions of otherwise uninsured children without disrupting private coverage. Claims that these proposals represent "a government takeover of the health care marketplace" are neither accurate nor likely to lead to wise policy that benefits children, according to Dorn. 3. With Children's Health Insurance Enrollment, Faster Is Better In my decades of work at Children's Hospital and Regional Medical Center, I've seen over and over how damaging and costly it is to treat a child who lacks health insurance. I've seen children show up in the emergency room and get admitted to the hospital for conditions that never would have gotten so out of control with regular care in a doctor's office. That's why I'm thrilled to learn that Washington is enrolling children in the newly expanded children's health coverage program even more quickly than anticipated. The short-term investment may be higher, but the long-term savings are huge. When legislators passed, and Gov. Chris Gregoire signed, the Cover All Kids bill this year (Senate Bill 5093), Washington stepped to the forefront of states creating a healthier future by making sure all children have health coverage. The program is comprehensive--including dental and mental health coverage--and affordable, with coverage available on a sliding scale to middle-class families with no other reasonable options. All families will be able to get the health insurance they need for their children. That coverage is available to all families is critical. In recent years employers have cut back dependent coverage, making it harder for working families to get and afford insurance. And, the fact of the matter is that all children get sick. No matter where parents work, no matter where children come from, we all pay when children get sick and can't pay to see a doctor. We pay for "charity care" in hospitals. We pay when they come to the emergency room. We pay because of overcrowding of these facilities. We pay when sickness spreads through schools. We pay if an uninsured child ends up needing extensive care that could have been circumvented through early detection and treatment. Just as important, we all pay when children can't live up to their full potential because they're hampered by illnesses or other medical conditions that shouldn't have to stand in their way. Washington doesn't pay for children's health coverage alone. Tens of millions of dollars come from the federal government through Medicaid and the State Children's Health Insurance Program. Those who are concerned about how Washington will pay for making sure all children can get medical care can make a difference right now. Congress is considering legislation to renew CHIP, which covers children in low-income families. This highly successful federal program has cut the uninsurance rate among low-income children in our nation by a third. Now is the time to build on CHIP's success. What's more, a relic of a rule from when CHIP was first created a decade ago means that Washington state doesn't get all the federal help it should. Everyone who cares about children's health should urge Congress to update the CHIP rules and invest more in the program. Sen. Maria Cantwell and members of the Washington congressional delegation are leading efforts to improve the CHIP program and need to know that Washingtonians support their work. Over several years, Washington has successfully pushed the children's uninsurance rate to 4.4 percent. We are so close to finishing the job. With help from the federal government and the efficient enrollment of eligible children we can make this generation of children the healthiest ever. [John Neff, Seattle-Post Intelligencer, 07/16/07] 4. Children's Health Funds at Risk Ten years ago, in one of its proudest moments, Santa Clara County became the first in the nation to set a goal of making sure every child has health insurance. The results have been nearly miraculous. Nearly every child under age 5 now has access to coverage. The number of uninsured kids has dropped from 70,000 in 1997 to roughly 11,000 today. That success has made the county a model for the nation. But the goal is not complete, and the gains so far are fragile. That's why Santa Clara County should lead the fight for Congress to continue to build on the funding of the nation's State Children's Health Insurance Program (CHIP). About 6.6 million children now are covered by the program. But health care costs are rising, so to maintain and build on that Congress is working on a plan to increase spending. Otherwise, thousands of kids in Santa Clara County--and millions across America--will fall off the roles of the insured. That makes President Bush's opposition to the proposed five-year, $35 billion budget increase unforgivable. Expanding health coverage to children has been one of Congress' highest domestic priorities this year. For good reason: Polls show that more than 80 percent of Americans favor universal coverage for children. Republican and Democratic leaders in the Senate deserve credit for forging the agreement last week on an increase in the cigarette tax to pay for the expansion. The Senate Finance Committee should unanimously approve the agreement and send it to the full Senate - which should send Bush a message by passing the bill with enough votes to override a veto. It's bad enough that roughly 46 million Americans lack health insurance. But the fact that 6.8 million children still have no coverage in this rich country is indefensible--especially since it does not reflect the will of the American people. Beyond the moral imperative, most Americans intuitively realize the long-term savings of providing coverage to children. Children who have access to medical care are demonstrably healthier than their uninsured counterparts. They're more likely to get routine checkups, where doctors can identify vision, hearing and speaking disabilities--problems that, if ignored, often result in bright children being tagged as "learning disabled." Healthy kids do better in school and are more likely to become productive members of society. The program before Congress isn't a giveaway. It provides for federal, state, and local governments to share the burden of taking care of poor children. For example, it provides states with federal matching funds to provide health care to children whose family income is too high to qualify for Medicaid but not high enough to afford private insurance. The states in turn offer matching funds to local governments hoping to expand coverage. Santa Clara County was one of the first to realize the potential benefits. It started the groundbreaking Healthy Kids program, which has provided low-cost health coverage to tens of thousands of children. Other counties saw the benefits and hopped on board. President Bush's opposition to the plan in Congress would be more acceptable if he proposed an alternative. But in his 6.5 years in office, he has done virtually nothing to reduce the number of uninsured children in the United States. The compromise plan provides hope for a healthier future for an additional 3.3 million uninsured children. Congress must fill the leadership void and guarantee that it becomes law. [San Jose Mercury News, 07/22/07]