Health Care Reform: What’s in It for Kids?

As our legislators craft their bills, the media is feeding us a relentless diet of health care debate coverage. TV, newspapers and journals, and the blogosphere report and opine tirelessly on questions of whether there will be a public option, how much health care reform will cost, how it will be financed, and others.

One question, however, is seldom addressed. Dr Steve Berman, professor of pediatrics at the University of Colorado School of Medicine, in his October 18th plenary address, “Health Care in the New Millenium: Improved Health Care for Children?” pointed out that the media aren’t asking “what about kids?” They aren’t examining the important question of whether children will be better or worse off with health care reform.

Dr Berman attempted to make up for this deficiency in the coverage of the debate by examining the probable and possible effects of proposals currently being considered by the House and Senate on 4 key cogs in the machinery of the reform:
 

•Access to care.
•Quality of care.
•Control of costs.
•Affordability.
 

Dr Berman noted that children stood to benefit from a number of components of bills currently under consideration. These include Medicaid expansion, CHIP continuation (tied to the Rockefeller amendment), the streamlining of enrollment processes, some aspects of Medicaid payment reform, and proposals that would incentivize the medical home.
 

However, there are other proposals on the table that could potentially have a negative impact on children. For example, the future of CHIP is uncertain. Also, there are concerns that some families would elect to pay the penalty and forgo coverage, that bills in their current state do not adequately address the needs of children of immigrants, and that plans may not have an appropriate pediatric benefit design. With regard to cost control, Dr Berman voiced concern that if legislators succeeded in tying Medicaid rates to those of Medicare (one proposal for controlling health care expenditures), the result would be a pyrrhic victory. Pediatricians, he pointed out, need a guarantee of adequate payment.
 

Dr Berman stressed the need for people to pay appropriate attention to these immportant and too-little-discussed issues. “No child should be worse off because of health care reform,” he concluded.