Chapter Committee on
State Government and Child Legislative Affairs

Patricia Flanagan, MD, Chair

Getting on Board with SCHIP Advocacy
The RI Chapter of the AAP and The New England Alliance for Children’s Health

For many years, the American Academy of Pediatrics at both national and state levels has maintained that all children should have access to comprehensive, age-appropriate, quality health care. Health insurance is a key factor in determining whether children receive the health care they deserve. As affordability of private insurance coverage has eroded, public health insurance programs, including Medicaid and the State Children’s Health Insurance Program (SCHIP), have stepped in to plug coverage gaps and ensure the availability of comprehensive coverage. SCHIP alone covers more than four million children nationwide, with over 11,000 of those residing in Rhode Island with RIte Care. While we have many successes to be proud of, over the past year much national and regional attention has been focused on key aspects of these public insurance programs, including concerns over cost, access, quality, and sustainability.

The RIAAP has traditionally played a strong role in influencing sound policymaking, and 2007 marks another opportunity to voice our support for children’s coverage – through a united stand in favor of the 2007 federal reauthorization of the SCHIP program with fair redistribution of other States’ previously unspent allocations. Current estimates show that RI will have a shortfall for SCHIP funding of $49.9 million by February 19, 2007. Further, if current plans for redistribution are carried out under H.R. 6164, RI will receive an additional $18.8 million from FY2004 and FY2005 funds, that will result in a delay of our eventual shortfall of $26.7 million by May 4, 2007.

Backed by strong bipartisan support, SCHIP was enacted for the ten-year term expiring in 2007 under The Balanced Budget Act of 1997. The program must be actively reauthorized by the present Congress. All practitioners should recognize that our SCHIP program, RIte Care, has been a resounding success story enhancing coverage and promoting access to care for many thousands of our youth. SCHIP extends coverage to children to age 19 residing in families with income modestly above Medicaid limits, yet unable to obtain private coverage – a group often termed “the working poor.” Much like Medicaid, SCHIP similarly represents a federal-state partnership. Unlike Medicaid, however, total yearly SCHIP funds are federally “capped” under a formula-driven allotment, giving the state much latitude in use of the targeted funds within broad federal guidelines. Our SCHIP program is administered in combination with Medicaid through RIte Care via managed care organizations providing eligible families access to a generous benefits package and for practitioners a transparent and reliable partnership with public insurance.

In support of SCHIP and mindful of the pending legislative opportunity, the RIAAP Board has voted, along with the other five New England AAP Chapters, to partner with a regional advocacy organization, The New England Alliance for Children’s Health (NEACH.) Coordinated through the regionally-based advocacy organization Community Catalyst, NEACH represents a growing coalition of New England providers, advocates, and business leaders, focused in three primary areas:

Federal - SCHIP reauthorization with funding sufficient to retain present coverage and benefits, while protecting Medicaid from threatened erosion
State – Defending and advancing health coverage for children
Quality – supporting efforts to enhance quality of pediatric care

At present the child advocacy “iron” is hot for several reasons. Since the decision to reauthorize SCHIP will be made in Washington over the next several months, timely development of a coordinated alliance of New England advocates not only builds upon provider successes to date in ensuring access and improving quality, but also leverages our national reputation in medical education and research. In addition, policy analysts and legislators nationwide are turning to New England states’ considerable past successes for guidance in innovative solutions to coverage of the uninsured. The spotlight is already upon us – time to take advantage of the opportunity!

Want to learn more?
For further information check out the NEACH website at http://www.childrenshealthne.org/ .
Sign and forward the attached Pledge showing your individual support.
Additionally, national AAP Department of Federal Affairs maintains updated information at http://aap.org/advocacy.html.
Or, feel free to email us at Robert.McCaslin@childrens.harvard.edu or asnyder@lifespan.org.

Submitted by:

Ian McCaslin, M.D., M.P.H., FAAP
Medical Director, Physician Outreach
New England Alliance for Children’s Health

Andrew Snyder, M.D., FAAP
President, RI Chapter, American Academy of Pediatrics