Category: CHIP

Why Medicaid is More Important Than Ever

  

Too often overlooked in recent debates is the role that Medicaid plays in children’s healthcare coverage. Of the 74 million Americans covered by Medicaid, nearly 36 million are children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) – which was enacted in 1997 to ensure affordable and accessible healthcare coverage for low-income children. Roughly 38 percent of American children receive healthcare services through these two programs, and they have been critical in increasing the percentage of American children with health insurance coverage to a historic high of 95.5 percent in 2016.

Medicaid and CHIP are particularly important to some of the nation’s most vulnerable children – 76 percent of children living in poverty, 48 percent of children with special health needs, and 48.8 percent of children ages three and under are covered under Medicaid and CHIP. Furthermore, 49 percent of births are covered by Medicaid. Without these two programs, millions of children would go without crucial healthcare services, positioning them for a lower quality of life further down the road.

And yet, despite the indubitably positive impacts that these programs have for America’s youngest and most vulnerable, Congressional Republicans and the Trump Administration have repeatedly attempted to scale them back and reduce the number of Americans who receive coverage. Congress voted on several bills in 2017 – all of which failed to pass both chambers – which would have reduced Medicaid eligibility, slashed funding, and imposed caps on state Medicaid programs. Congress also chose to play political football with CHIP, which expired on September 30, 2017, and did not re-authorize the program until January 2018, a full four months after its funding had expired. The Trump Administration has also opened the door for states to impose work requirements on Medicaid recipients. These proposals have all been aimed at low-income Americans, who are burdened enough already as they work to make ends meets.

Reducing coverage to reduce poverty and encourage work is counterintuitive given that Medicaid actually encourages Americans to remain employed, and implementing such proposals would have drastically negative impacts on the nation’s low-income and vulnerable populations. Seventeen percent of American parents receive health insurance coverage through Medicaid; reducing Medicaid eligibility and funding for adults would also reduce coverage for those children whose parents receive coverage through Medicaid. Medicaid also helps to keep millions of Americans out of poverty and out of debt. The burden of this reduction in coverage, meanwhile, would fall equally, and unfairly, on parents and their children.

While CHIP has been fully re-authorized for 10 years and there are currently no legislative proposals to roll back Medicaid coverage that appear close to passage this Congress, it is important to recognize not only during this Medicaid Awareness Month, but all year, the impact the Medicaid has on such a large segment of Americans. ANA continues to support universal access to affordable and accessible healthcare coverage and continues to stress the importance of preventive services. Medicaid and CHIP are some of the most important programs toward achieving those principles, and we urge Congress and the Trump Administration not to jeopardize Medicaid coverage for any Americans.

Congress Passes Bipartisan Spending Measure with Funding for Critical Health Programs

  

Following a brief, overnight government shutdown, President Trump this morning signed a spending measure and continuing resolution which reopens the government and provides funding through March 23rd while setting broad spending levels through FY 2019. The measure provides roughly $500 billion in additional funding over the next two years, including roughly $140 billion in additional non-defense domestic spending, a similar increase in defense spending, and roughly $90 billion in federal relief funding for Puerto Rico, the U.S. Virgin Islands, Texas, and Florida, which were pummeled by devastating hurricanes last summer, and for those impacted by the California wildfires. The bill also waives the debt ceiling until March 1, 2019.

Crucially, the spending bill provides additional funding for some of the nation’s most important public health programs. It provides $7 billion in funding for the nation’s 2,600 community health centers, which provided care to 26.5 million Americans in 2016; this was a critical need and the $7 billion in this bill represents roughly 2 years of federal funding for the nation’s centers.

The spending measure also extends the Children’s Health Insurance Program (CHIP) for another 4 years, meaning that the program will now be fully funded at the federal level for 10 years. CHIP provides healthcare coverage for roughly nine million American children and is a critical provider of healthcare services. The measure also provides an additional $2 billion in funding to the Department of Veterans’ Affairs to better manage their health system and prevents automatic cuts to Medicare and Medicaid, while eliminating the Independent Payment Advisory Board (IPAB). The measure critically provides $6 billion in funding over the next two FYs to fight the opioid epidemic.

With a large portion of the nation’s fiscal policy taken care of, the House and Senate have now cleared their plates to work on a solution to the Deferred Action for Childhood Arrivals Program, better known as DACA. The Trump administration plans on ending the DACA Program on March 5th, giving Congress roughly four weeks to come up with a solution to shield hundreds of thousands of young immigrants from deportation. ANA supports the DACA program and urges the House and Senate to quickly come to an agreement to keep these young Americans in the country. The Senate has already taken up a measure this morning to begin debate on the fate of DACA; ANA will continue to monitor this important issue.

We applaud Congress for coming to a bipartisan, long-term spending deal which ensures that several of the nation’s most important healthcare programs receive long-term funding. CHIP, the nation’s community health centers, and the VA all provide critical healthcare access to some of the nation’s most vulnerable populations, and Congress should be commended for recognizing their importance.

ANA also applauds Congress for providing additional funding to areas hit hard by this summer’s devastating hurricanes and by the wildfires in California; the American Nurses Foundation teamed with the Texas Nurses Association in August to raise donations for victims, and numerous nurses went down to Texas, Florida, and the Caribbean to help out. The spending measure signed into law this morning, however, only provides funding for the government through March 23rd; until then, members of Congress will continue to work to hammer out appropriations for federal agencies and programs for the remainder of FY 2018 and FY 2019. We strongly urge you to make your voices heard and let your member of Congress know that funding for the nation’s healthcare programs is critical to the overall health of the nation.

Photo Credit: Tom Brenner/The New York Times

Congress reopens the government and reauthorizes CHIP while HHS creates a Conscience and Religious Freedom Division

  

Earlier today the Senate announced a deal for a three week continuing resolution to reopen the government. While this is an important step, ANA continues to advocate for a long-term, bipartisan solution to provide Americans with a greater sense of stability. In particular, we encourage both chambers to find an equitable compromise for the Deferred Action for Childhood Arrivals (DACA) program.

Included in this deal was a six year reauthorization of the Children’s Health Insurance Program (CHIP). It’s been more than 100 days since this vital, bipartisan program, which provides health coverage to 9 million children and pregnant women, was fully funded, and many Americans across the country worried that their family’s health care could run out. Nurses were critical in securing this win and we can’t thank you enough for reaching out to your representatives in Congress demanding a long term solution.

The shutdown and CHIP reauthorization are not the only important issues developing in Washington. Last Thursday, the Department of Health and Human Services announced it was establishing a Conscience and Religious Freedom Division under the Office for Civil Rights. This new division is charged with enforcing current laws that protect nurses and other health professionals who refuse to provide care to which they have moral or legal objections.

While health care professionals are obligated to follow laws and the federal government has the obligation to enforce these laws, both parties have the important responsibility to ensure that all patients receive the care and treatment to which they are entitled. All health care professionals’ first priority should be the quality and equal access of care their patients need. That is one of the reason that several organizations, including the National Women’s Law Center, the American College of Obstetricians and Gynecologists and the Human Rights Campaign, have expressed concerns that this new division could cause increased discrimination among certain groups of patients.

There are also legitimate concerns that this new entity could hinder or even deny some patients the care or treatment options open to them. Far too often vulnerable populations experience discrimination when it comes to their health care. Patients rely on nurses to provide honest and professional medical advice and treatment during the course of care regardless of their own beliefs. It is vital that all patients, regardless of their beliefs, sexual orientation, gender or health care needs know they are receiving the most accurate and timely care.

This issue is extremely important to the nursing profession. In response to this announcement Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, president of the American Nurses Association (ANA), issued the following statement:

“The American Nurses Association Code of Ethics for Nurses with Interpretive Statements states that a nurse has a duty to care. It also states a nurse is justified in refusing to participate in a particular decision or action that is morally objectionable, so long as it is a conscience-based objection and not one based on personal preference, prejudice, bias, convenience, or arbitrariness. Nurses are obliged to provide for patient safety, to avoid patient abandonment, and to withdraw only when assured that nursing care is available to the patient. Nurses who decide not to participate on the grounds of conscientious objection must communicate this decision in a timely and appropriate manner, in advance and in time for alternate arrangements to be made for patient care. Nurses should not be discriminated against by employers for exercising a conscience based refusal.

However, we must take care to balance health care professionals’ rights to exercise their conscience with patients’ rights to access a full range of health care services. Discrimination in health care settings remains a grave and widespread problem for many vulnerable populations and contributes to a wide range of health disparities. All patients deserve universal access to high quality care and we must guard against erosion of any civil rights protections in health care that would lead to denied or delayed care.”

Discrimination, prejudice and bias have no place in the American health care system and no patient should have to worry they aren’t getting the timely or medically necessary treatment they need. Nurses will continue to advocate for their patients to prevent discrimination and ensure that all Americans receive the high quality care they are entitled to. As the Department of Health and Human Services moves forward with this undertaking we will continue to monitor not only the implementation of the Conscience and Religious Freedom Division but the activities coming out of it to ensure that patients and health care professionals are protected.