This week my colleagues and I added up the pages of health reform legislation we have read. Can you tell we were trying to avoid focusing on the most recent 1,990 page bill released by the House of Representatives? The tally adds up to 53,148 pages of health reform bills read by seven people in my office. And it’s not over yet…
 
Most recently, the health reform bill that will go to the House floor, The Affordable Health Care for America Act, holds the promise of health coverage for almost all Americans, including children. And we are still awaiting a merged Senate bill that will be voted on in that chamber.

Now for a quick recap on where we are and how we can continue to influence what is included in health reform in the end.

The most recent House bill does not address a major issue in the delivery of children’s health care which is access to pediatric specialty care reimbursement inequities between the Medicaid and Medicare programs are at the heart of the issue. On average, pediatric specialists are reimbursed one-third less under Medicaid than under Medicare. With a limited number of physicians opting to specialize in pediatric specialty care and a smaller number willing to participate in a program that does not fairly compensate them for the care that they provide. Families already experience long wait times for appointments to see specialists such pediatric cardiologists and pulmonologists due to critical workforce shortages. Fair reimbursement will help resolve this inequity.

The House bill would also cut a funding mechanism that benefits all safety net hospitals, including children’s hospitals. Without addressing the severe shortfalls due to Medicaid reimbursements, the cuts could hinder services available to children. To put a finer point on the issue: the average annual Medicaid shortfall experienced by just one children’s hospital requires 237 or nearly eight months of non-Medicaid operating income to recoup.

At this point, there is little you and I can do to influence changes in the House bill before it goes to a vote. However, there is still time to impact the Senate health reform bill and what comes out of conference that will have to reconcile changes once both bills pass their respective chambers.

The current Senate health reform bill keeps children currently eligible for the Children’s Health Insurance Program (CHIP) in the program post health reform. However, it does not reauthorize the program past 2013 or provide adequate funding for the continuation of the program. Nor does it protect the cost-sharing provisions that would keep families out-of-pocket health expenses from escalating. Finally, the bill does not address the critical issue of access to care by increasing reimbursement rates to pediatric specialists under Medicaid to rates comparable to specialists compensated under Medicare.

There is more opportunity to offer amendments and changes to the Senate bill so I urge you to raise your voice in unison with us and send your Senator a letter urging him or her to protect children in health reform by including the following provisions in their final legislation:

1. Extend and fully fund CHIP through 2015.

2. Protect children currently covered by CHIP and Medicaid by guaranteeing that they will have comparable coverage, benefits and cost-sharing protections before they can be moved into the newly created Health Insurance Exchange.

3. Improve children's access to pediatric specialists by increasing Medicaid reimbursements to rates no less than Medicare by 2012. And minimize cuts in safety net payments that would have a negative effect on children’s hospitals.

Get started on your letter now before Congress makes critical decisions that impact children’s health care.