November 12, 1999
Washington, D.C. — The American Academy of Pediatrics announced a new health insurance proposal that would create a national program in which all children and adolescents through age 21 are automatically eligible. The new program would have uniform eligibility, benefits and administrative procedures. If enacted, it would replace Medicaid and the State Children's Health Insurance Program (SCHIP).
"The world's most powerful democracy has 11 million uninsured children," AAP President Joel J. Alpert, M.D, said in his address during the AAP Annual Meeting in Washington, D.C. "There is no excuse for it. We can solve this problem."
"This new proposal is politically viable because it serves many constituencies," Dr. Alpert explained. "Most importantly, it serves children by providing every child with quality health insurance coverage. It serves parents because they will be able to enroll their children in a program with the assurance that the coverage will never be taken away. It serves the public because it uses health dollars wisely. And this proposal serves pediatricians by ensuring value for their services."
Families may choose to enroll their children in a private insurance plan or they will be automatically enrolled in the national program. This program will require an increased investment in children's health, a majority of which is needed to get private plans to meet quality standards. The American of Pediatrics is looking at a variety of mechanisms in which to fund the proposal.
Although the Academy will continue to work with Medicaid and SCHIP until the new program becomes reality, there is a need to act as soon as possible lest the numbers of uninsured continue to grow.
"With Medicaid and SCHIP, families must overcome substantial enrollment barriers," Dr. Alpert said. "Race, language, culture and geography all hamper those who are eligible. Recipients must overcome bureaucratic hurdles and cumbersome enrollment procedures. Even when these barriers are overcome, eligibility must be re-established, because enrollment is time limited. These programs require means testing, which varies from location and income. This is why we find millions of children who have no insurance despite being eligible."
The key elements of this proposal would include:
All children will be automatically eligible without means testing. Family contributions would vary according to family income.
Families may choose to enroll their children in a private insurance plan or they will be automatically enrolled in the new national children's program. Incentives will be developed to minimize further erosion of employer-based contributions.
All programs, public and private, would meet the American Academy of Pediatrics' benefit standards.
All children will have access to primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists.
Assurances will need to be developed to ensure the quality and integrity of all programs. For example, states would be responsible for program oversight, accountability and quality monitoring.
Every attempt will be made to capture the existing contributions to child health insurance from federal, state and private sources.
Enactment of this proposal would increase societal spending on child health by about $44 billion a year. The major reason for this increase in spending is the need to have all private plans meet quality standards.
The American Academy of Pediatrics will continue to work with its membership as well as with policymakers, parents, and the business and medical community to ensure a final plan that can be embraced and enacted.
The American Academy of Pediatrics is an organization of 55,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health and well being of infants, children, adolescents and young adults.
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