Guest Post: Andrew Leonard, Senior Health Policy Associate, Children’s Defense Fund-NY
Even with the expansion of affordable coverage to over two million New Yorkers, work remains to eliminate persistent health disparities across economic, racial and ethnic lines.
As advocates and consumers, we work to foster a New York where children are not just insured, but healthy and happy. We believe that coverage must lead to care, and care must lead to health and wellness for all New York children.
One of the most promising models for connecting children and families to care involves the delivery of health care services in schools. While schools are primarily educational institutions, they are uniquely positioned to be effective health care access points. Schools are a gathering place for practically all children and offer a comfortable space in which students can receive primary, dental and behavioral health care services that may be hard to find in their own communities.
In recent years, schools have swiftly developed the capacity to provide preventive and primary care services along with robust chronic disease management, all while keeping a child from missing precious academic seat time. School health services can include health clinics adjacent to classrooms, nurses performing complex medication management, and much more.
Schools are particularly adept health care access points for immigrant children. For families who are new to the United States and lack connectivity to existing health care providers, schools can facilitate enrollment in an affordable health plan and provide immigrant children with their first contact to essential health services in the US. School-based mental health care fosters a space in which immigrant children can receive needed services as they go through the process of adjusting to a new culture and, often times, a new family dynamic. Schools have played a tremendously important health care role for the nearly 6,000 unaccompanied immigrant children that arrived in New York State in 2014 after escaping violence and economic inopportunity in Central America.
School-based health clinics are also effective vehicles for eliminating racial and ethnic disparities in the communities that they serve. In New York State, approximately 25% of these clinics serve communities where more than one-third of the population lives below 100% of the Federal Poverty Level. Seventy-nine percent of students in schools with centers are non-white with more than 30% identified as Black or African-American.
With such an ability to provide services, schools must be considered an integral player in the larger children’s health infrastructure. That is why we at The Children’s Defense Fund – New York are excited about our new report on school health in New York City: Health + Education = Opportunity: An Equation that Works. The report, made possible with financial support from the Altman Foundation, describes the city’s current school health system and explores ways to better expand this care.
CDF-NY is hosting an event on Friday, May 15th called, The Winning Equation: A Panel Discussion on the Role of Healthcare Services in NYC Schools, to further dive into this topic. Please, join us if you can! Click here for more info.
Late last night, the Senate passed H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), a bi-partisan legislative package originating in the House of Representatives that, among other things, reauthorizes funding for the Children’s Health Insurance Program (CHIP) for two years, through 2017.
HCFANY and other leaders in healthcare advocacy supported a four-year extension. Extending the program for two years is a great initial step to protect children and families, and quick action to extend the program will help states (including NY), that rely on this assurance for budget planning (we blogged about this here and here). Now, HCFANY will keep working with State leaders and members of Congress to make sure the program is protected beyond 2017.
Read our full press statement here.
Federal funding for the Children’s Health Insurance Program (CHIP) will run out in September 2015 unless Congress agrees to extend it. A failure to do so would undermine children’s health insurance in all 50 states, including New York.
A brief background of CHIP and Child Health Plus
Created in 1997, CHIP has helped states like New York achieve nearly universal coverage by offering affordable, comprehensive coverage to children who don’t qualify for Medicaid. CHIP provides federal matching funds to state governments, allowing them to operate health insurance programs that are tailored to the specific needs of children in that state. The product of a Republican-controlled Congress and a Democratic president, CHIP is a bipartisan success story.
Of the eight million children who rely on CHIP today, half a million live in New York State, where all children who are residents under the age of 19 are eligible for the state’s version of CHIP, Child Health Plus (CHP). Families who earn below 400 percent of the federal poverty level can get subsidies to help them afford CHP.
Where’s the funding, Congress?
New York and other states are now drawing up their budgets for the next fiscal year. With CHIP’s funding slated to run out in mere months, governors and legislators, as well as families, need assurance that funding will continue. Governor Cuomo of N.Y. and 38 other governors have sent letters urging immediate renewal of CHIP and warning of the disruption any delays may cause for families who rely on CHIP.
- Extend CHIP funding through 2019
- Maintain the 23-percentage increase in federal matching rates established by the ACA
- Continue initiatives to measure and improve pediatric quality of care
On February 24, Republican leadership – Senate Finance Committee Chairman Hatch (R-UT), Senate Energy and Commerce Committee Chairman Upton (R-MI), and House Energy and Commerce Health Subcommittee Chairman Joe Pitts (R-PA) – released a discussion draft for a third, alternative CHIP bill.
It’s a welcome sign that both sides of the aisle appear to be committed to extending CHIP. However, the Republican proposal has several downsides. Health advocates say that that Hatch-Upton-Pitts bill, if enacted, would result in reduced funds for states, potentially longer waiting periods for children, and the elimination of vital protections that could allow states to roll back coverage. (For more info, read this and this.) For example, the bill would eliminate federal match funding for families earning over 300% of FPL – a big hit to New York’s program, which provides subsidized coverage to families up to 400% FPL. The chairmen are currently inviting comments on their proposal.
Clashing visions of CHIP in Congress means we can expect further delays before a final decision is made on CHIP funding. Meanwhile, time is running out for millions of families in New York State and across the country.
Join or follow the conversation online by exploring the hashtag #ExtendCHIP on Twitter
“The Affordable Care Act gave me a chance and ended my six year nightmare of living without health insurance. It was way more simple and affordable than people think.”
-Karen E., Ulster County
The Affordable Care Act is working in New York, according to HCFANY’s new publication, The ACA is Working: New Yorkers Tell Their Stories.
The new publication shares stories from New Yorkers like Karen, a single mother from Ulster County, who was finally able to get affordable health coverage for her family after being uninsured for six years, thanks to federal subsidies. Ben, from Broome county got covered thanks to the ACA’s Medicaid Expansion and enrolled in the same plan as his son. And Engracia got help from a local Navigator to enroll in a plan that saves her $4,500 a year.
The ACA is Working: New Yorkers Tell Their Stories features twelve consumer stories and quotes from New Yorkers in all regions of the State who enrolled in private Qualified Health Plans, Medicaid, Child Health Plus, and small business plans, all through the NY State of Health Marketplace during the first Open Enrollment period. Many got help to enroll from Navigators, who offer free, unbiased, in-person enrollment help. The stories are paired with key statistics and facts about how the ACA is working for New York – and most importantly, New Yorkers.
View HCFANY’s full press release here.