In 2008, the number of uninsured children in the United States hit the lowest level in two decades. If Congress weren’t in the middle of a fierce debate on health reform, there would be time for everyone to celebrate a remarkable achievement and maybe even pause to reflect on how it was accomplished. To paraphrase David Byrne of the Talking Heads: “We might ask ourselves, how did we get here?” We got here with federal fiscal support, leadership, state ingenuity and a willingness to make a sustained effort to address the issue of uninsured children. The states deserve a lot of credit. It’s been impressive to see how state policymakers from across the political spectrum have rallied to support children’s coverage, despite facing tough economic obstacles in recent years. Even in the midst of terrible fiscal problems, the vast majority of states have maintained children’s coverage in Medicaid and CHIP. This year so far, a whopping twenty-three states found a way to expand or improve children’s coverage, proving what can be accomplished when the federal government is a strong fiscal partner.
Federal policymakers deserve a big share of the credit by providing strong fiscal incentives for states to strengthen Medicaid and CHIP coverage for children. Earlier this year, Congress and the Administration took steps to sustain the momentum by enacting the Children’s Health Insurance Program Reauthorization Act and increasing the federal matching rate in Medicaid to prevent cutbacks in eligibility. These initiatives have already proven to be successful and are providing a positive impact across the country. Children’s health care advocates have also done a great job of making sure the needs of children were not relegated to the back burner as he Recession unfolded. They worked tirelessly in Washington, D.C. and in state capitols across the country to make sure policymakers couldn’t ignore the children. As a result, the lifeline of Medicaid and CHIP were available to uninsured children just when they needed it most. Credit also goes to all the families who were willing to publicly share their private pain of facing health care costs without adequate insurance coverage. By sharing their stories, they reminded us that any one of us could face the same situation if one of our children fell ill and our private coverage came up short, we lost our jobs and our access to affordable family coverage or our wages just didn’t keep up with the steep increases in our premiums. And, in some cases, they paid a heavy price for their willingness to go public, including below-the-belt attacks by bloggers. There is enough credit to go around on this good news for uninsured children but there is a broader lesson to be learned. If we can drop our ideological straight jackets and work for the common good, we can move forward together and continue to make progress. If the federal government puts its money where its mouth is and state governments cut red tape and focus on serving urgent human needs, children and their families can get the quality, affordable coverage they need. This good news on the “uninsurance” rate for children should reinvigorate those who are working to make sure not only children but their parents and other adults have the opportunity to secure affordable health insurance. It’s time to move beyond “same as it ever was” by ending the bickering and finger pointing. It is imperative that States, Congress and the Administration build on the success of CHIP and Medicaid and upon the remarkable progress they have made in combating the “uninsurance” problem among children.Jocelyn Guyer is the Co-Executive Director of the Center for Children and Families at Georgetown University’s Health Policy Institute.