By Marian Wright Edelman
February marks the third anniversary of the Child Health Insurance Program Reauthorization Act (CHIPRA), which has made significant improvements in health coverage for millions of children. About two-thirds of all uninsured children are eligible for Medicaid or CHIP but are not enrolled due largely to bureaucratic barriers. CHIPRA has addressed those barriers head on by including performance bonuses to encourage states to simplify their enrollment procedures and meet targets for enrolling the lowest income children. Millions of dollars in outreach and enrollment grants also have helped target eligible but uninsured children and connect them with health coverage. CHIPRA has extended the reach of these critical child health programs that together served more than 43 million children in 2011 – children like Jyla Bell.

Jyla, age nine, has cerebral palsy, rheumatoid arthritis, and a mood disorder. Her left side is weak and she has holes in her spine and wears a back brace for support. She also has trouble retaining information. Her mother, Amy, whose income is below the federal poverty level and who has serious health needs of her own, can’t afford private health insurance or education. Forty years ago, a child with Jyla’s physical and mental disabilities may well have been placed in an institution but today, the child health safety net – including Medicaid – makes it possible for Jyla to live at home with her mom and older brother Cornez and attend public school.

Medicaid provides tens of millions of children who are poor or have disabilities with comprehensive health coverage enabling them to become productive, taxpaying members of society. Without Medicaid’s strong protections, coverage guarantee, and individualized health and mental health care, many of these children would go uninsured, increasing costs for states and local communities. Medicaid is the single largest health insurer for children, providing health coverage to almost 35 million low income children and another 1.4 million children with disabilities. Together Medicaid and CHIP – the Children’s Health Insurance Program – insure one in three children , six in 10 low income children, and four in ten children with special health care needs. Health coverage costs more than $14,000 a year for a family of four – almost as much as a parent would earn working full time at minimum wage. About

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