Friday, December 6, 2013
How we treat the most vulnerable members of our society says a lot about the kind of society we are.
A child is vaccinated in Vermont in 2012. A 1999 MaineCare expansion made it more likely that Maine kids would get preventive care such as vaccines.
2012 File Photo/The Associated Press
Nowhere is that more true than in regard to our treatment of children. How well are they being educated? How many of them are living in poverty? Are they healthy, and are they getting the care they need to stay healthy? Are they being raised in families, neighborhoods and communities that nurture them?
Maine ranked first among the states in terms of the health of its children, according to a private charity's recent report on the status of American children, even while the number of children living in poverty grew.
This speaks volumes to the critical importance of safety-net programs in tough times and to the foresight state lawmakers showed when they expanded eligibility for health insurance under MaineCare to include more low-income children and pregnant women, in one of a series of steps starting in 1999. These decisions have been the focus of much second-guessing over the past few months.
Gov. LePage said they made the program so big that he wasn't comfortable taking federal funds to expand MaineCare eligibility once again. But MaineCare has worked for Maine children, and the recent critical rhetoric surrounding it has been both unfair and unfounded.
Health insurance can make a big difference in children's lives, starting even before they're born. A child whose mother is insured and gets adequate prenatal care is more likely to be born at a healthy birthweight. (Low birthweights -- less than about 5.5 pounds -- are associated with developmental problems and short- and long-term disabilities.)
Later on, children with coverage are more likely than uninsured children to be diagnosed early, allowing for treatment before a chronic condition like asthma or ear infections becomes worse. They're more likely to get immunizations, which prevent disease. They're less likely to receive treatment in hospital emergency rooms and more likely to be cared for, at less expense, in a doctor's office.
With all this in mind, it's easy to see why the Annie E. Casey Foundation's Kids Count report uses the percentage of children without insurance as a way to measure children's health. The more children who are covered, the better their health.
Maine's children are the healthiest in the nation, according to the recently released Kids Count report. Between 2005 and 2011, the percentage of Maine kids without insurance dropped. Only 5 percent of Maine kids -- 14,000 -- lacked insurance in 2011.
That's still too many kids, but it's better than the 7 percent national average. And fewer Maine babies -- 6.3 percent, or 814 -- were born below a normal weight. (The national average is 8.1 percent.)
Legislators have helped make it happen. They extended eligibility beyond Medicaid income limits to include more pregnant women and low-income children living in poverty. Maine children and pregnant women whose families earn 200 percent of the federal poverty level -- that's $47,100 for a family of four -- qualify for MaineCare.
The expansion of eligibility standards helped ensure coverage to Maine children from 2005 to 2011, when the number of kids living below poverty level rose from 17 percent to 19 percent.
But while LePage and his allies are eager to cite MaineCare as a program gone out of control, it's more likely it was responding to the hardships imposed by the Great Recession. Health care needs don't go away just because the government doesn't want to spend money to address them; the longer they go unaddressed, the worse they get.
Meeting the demand for care with facts instead of rhetoric is the best way to make sure that the people least able to bear it -- Maine's children -- don't bear the brunt of the state's hard times.