View from Washington


Adolescent Health and Health Reform

By Brent Ewig, MHA 
Director of Public Policy & Government Affairs, AMCHP

The health reform debate in Washington is heating up, with many positive signs that this may finally be the year to get comprehensive health reform across the finish line. One not so positive sign however is a sense on Capitol Hill that kids’ issues were covered by the CHIP reauthorization, and therefore the focus on health reform is really on adult coverage. The phenomenon is being dubbed “CHIP fatigue.” Even more troubling is the potential that a focus on adults could be to the detriment of children and might further squeeze out attention to the unique health needs of adolescents. Rest assured that AMCHP and its partners are advocating loud and clear that no matter how tired we are, health reform can simply not afford to overlook the unique needs of all women, children, adolescents, and children with special health care needs.

One of our key messages is if we want to truly focus on controlling chronic diseases then we need to invest in public health programs – like the Title V MCH Block Grant – that work with teens to avoid developing the habits in adolescence that will likely lead to chronic diseases in the future. Unfortunately, much of the debate to date has been on the expansion of disease management programs among Medicare populations. Our response has been that disease management and care coordination are crucial, but beginning this focus with Medicare eligible individuals is like trying to build a sky scraper starting on the 65th floor.

As noted, we have spent much time over the past few weeks in meetings with key Congressional staffers sharing our AMCHP Principles for Health Reform. We have also participated in a coalition of children’s health advocate that meets regularly with key staff for the Senate HELP Subcommittee on Children and Families. This group includes the Academy of Pediatrics, March of Dimes, American College of Obstetricians and Gynecologists, National Association of Children’s Hospitals, Family Voices and others. One of the key partners that emerged for us in these meetings is the National Alliance to Advance Adolescent Health. Together we have been reinforcing messages with key Hill staff that the insurance benefits package for adolescents needs to meet their unique needs and at a minimum include what has been dubbed “the –entals,” namely dental, mental, and developmental services. We are stressing that a strong benefits package that meets the unique needs of adolescents is essential, and that the comprehensive, confidential family planning services are also vitally important.

We expect to see bill language for health reform legislation soon and will then know if our advocacy efforts have paid off and what additional education on key adolescent and MCH issues needs to continue.

Finally, in a bit of breaking news, we wanted to highlight that the president’s budget - released right at press time - proposes to eliminate funding for abstinence education and in its place, fund teen pregnancy prevention at $110 million. We are seeking additional details and will report more in the next Legislative Corner of AMCHP’s Member Briefs.