News-Letter

President Franklin Delano Roosevelt, founder of the March of Dimes, wrote in a November 1942 letter,"c9nothing is closer to my heart than the health of our boys and girls and young men and young women. To me it is one of the front lines of our National Defense." The U.S. Congress should keep President Roosevelt's words in mind as they consider the reauthorization of the State Children's Health Insurance Program (SCHIP).

MCHIP, the Maryland Children's Health Insurance Program, provides health insurance coverage for children and pregnant women who meet income guidelines. In Maryland, about 95,000 children are enrolled in MCHIP, yet 133,000 children remain uninsured. Congress is expected to consider the reauthorization of SCHIP this year and the March of Dimes believes this is a perfect opportunity to take the following steps to make the program even moreeffective.

First Congress should provide the resources necessary for states to enroll all eligible children. Today, more than 6 million children rely on SCHIP for their health insurance. But nearly 2 million (about 19 percent) of the 9 million children who are not insured are eligible for SCHIP and yet enrolled.

The National Academy of Sciences' Institute of Medicine has shown that health insurance status is the single most important influence in determining whether health care is accessible to children when they need it.

Second, Congress should allow states to enroll pregnant women who meet the SCHIP income guidelines. Numerous studies have shown that health insurance coverage is essential to ensuring that pregnant women have access to the medical care they need to give their babies a healthy start in life. Currently, states can enroll pregnant women in SCHIP only if they obtain a federal waiver or follow a regulatory approach that fails to cover the scope of clinically recommended maternity care. Congress should amend the SCHIP law to give states the option to enroll pregnant women who meet the program's income guidelines.

Third, Congress should improve access to medical services for children with special health care needs. Under current law, a child must be totally uninsured in order to qualify for SCHIP. Unfortunately many families are left underserved by this arrangement.

A better approach would be to permit families with some private coverage to enroll their child in SCHIP as well. Together the two plans can provide the scope of benefits that meet their child's medical needs. Because private plans would cover a portion of the health costs incurred by these children, allowing families to combine private and public coverage would make it possible for states to stretch their SCHIP dollars to reach more children.

Fourth, state monitoring and reporting on the quality of care provided to children enrolled in the program should be improved. Monitoring the quality of preventive and chronic care services for the pediatric population would enable parents and policy makers to better assess and, where necessary, improve the quality of care provided through this program.

I call on our U.S. senators and representatives to extend and strengthen SCHIP according to the recommendations outlined above.

As Hopkins students, we are the future leaders of this nation's health care system. We should take it upon ourselves to encourage our nation's leaders to improve on this vital piece of legislation. As President Roosevelt so eloquently said, the health of our children should be a national priority.

Elizabeth Caudle is a sophomore International Studies major from Gainesville, Fl. She is the Northern Region Vice Chair of the March of Dimes National Youth Council.

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