The War on Poverty and Children’s Health

Health
Poverty & Family Economics

“Because of this document–and the long years of struggle which so many have put into creating it–in this town, and a thousand other towns like it, there are men and women in pain who will now find ease. There are those, alone in suffering who will now hear the sound of some approaching footsteps coming to help. There are those fearing the terrible darkness of despairing poverty–despite their long years of labor and expectation–who will now look up to see the light of hope and realization.”

Those are the words President Lyndon B. Johnson spoke in Independence, Missouri at the signing of The Social Security Amendments of 1965 that created Medicaid nearly 50 years ago. At that time, the national poverty rate was just under 20 percent and drastic measures had to be taken. Sensing the pain and suffering throughout the country, President Johnson declared a national War on Poverty to aid families that struggled to feed, house, and take care of their children. Seeing health, education, and public welfare assistance as tools to combat poverty, President Johnson created programs to address the hunger, lack of early care and education, and poor health of America’s children.

The powerful words and complementary actions of President Johnson rang true for millions of children and parents in low-income families and also for nearly half of America’s seniors and people with disabilities. After decades of work that initial began by President Harry Truman who first proposed national health insurance in 1945, these same vulnerable populations now had access to something they lacked for so long: access to real health care.

An option by design, Medicaid gave states the choice to cover children from poor families who were not on welfare. It also created the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program, designed specifically for children’s health needs. Every state, except Arizona that didn’t take up Medicaid until 1982, had implemented Medicaid by 1974. States varied in whom they made eligible for the program such as families who received welfare benefits, the elderly, and the medically needy. It wasn’t until the 1980s that Medicaid requiredstates to cover low-income children and pregnant women. That federal change, requiring coverage of those two populations, made Medicaid the largest insurance source for children in the country.

Throughout the years, Medicaid and EPSDT have changed and adapted both federally and state by state. Today, Medicaid serves as the cornerstone of health coverage for our children, providing coverage to 31 million kids in 2009. More than one-third of all American children get their health care through Medicaid and half of all enrollees are children. More broadly, it is the source of coverage for one in five Americans. Without Medicaid, the very poorest people in our country would be uninsured and millions of children would not have a regular source for basic health care services. It’s hard to imagine life without Medicaid for kids – where would our most vulnerable children go for healthcare? How would their families endure the lack of needed care for cancer or developmental disabilities, or even just ear infections? Because of Medicaid coverage for children, countless families over the last 50 years have not faced medical bankruptcy due to medical bills.

As much as Medicaid has helped families keep their children healthy and receive the health care needed, Medicaid has also prevented and lessened the pain of poverty for millions of families. As Diana Rowland wrote in 2005, “Medicaid financing has helped move many low-income families from dependence on charity and free care to financial access to both public and private providers. In doing so, it has offered assistance to millions of low-income children and adults and provided a healthier start in life to many of the Nation’s children. The coverage provided by Medicaid has helped to narrow the gaps in access to care faced by those without insurance and promoted broader use of preventive and primary care services. Medicaid’s impact on low-income families can be seen both in the numbers of people served and the access to care provided.” In short, Medicaid works and Medicaid plays a significant role in keeping kids healthy.

Along with Medicaid, the Children’s Health Insurance Program (CHIP) provides health coverage to more than seven million low-income children in families. Families with children covered by CHIP have incomes too high to qualify for Medicaid, but don’t earn enough to purchase private health insurance on their own. Approximately 42 percent of U.S. children get their health coverage through Medicaid or CHIP. For more than a decade, CHIP has been an enormous success for kids. Since its inception in 1997, CHIP has reduced the number of uninsured children by almost a third, even as uninsured rates for adults increased steadily.

The rates of poverty in America continue to be a battle we must fight. In 2012, we defined poverty as a family of four whose income was below $23,283.According to statistics there were 16.1 million, or 21.8 percent of children, living in poverty in the United States compared to 46.5 million, or 15 percent of all Americans.

We can do better. Medicaid and CHIP cover one in every three children. Both programs, Medicaid at almost 50 years old and CHIP at 17 years, are vital and essential tools in the War on Poverty – millions of America’s children and their families depend on them.