American College of Physicians: Internal Medicine — Doctors for Adults ®


ACP takes stand on implementing children's health

From the November 1997 ACP Observer, copyright 1997 by the American College of Physicians.

By Elizabeth Prewitt

Although legislators recently included $24 billion over five years in the federal budget to provide health care to uninsured children, the College's advocacy of "children's first" legislation is far from finished.

Now that the Children's Health Insurance Program (CHIP) legislation has been finalized, ACP is working with an informal network of organizations led by the American Academy of Pediatrics to address concerns about how new programs will be implemented. (Information about CHIP is available on HCFA's Web site at

The way in which states use the funds earmarked for children's health care—whether as expansions of existing Medicaid benefits or entirely new programs—will affect not only the children who receive new coverage, but other groups of uninsured who may get coverage in the future. As a result, states must not only design programs that meet the needs of low-income uninsured children, but also anticipate future expansions that would provide health care coverage to all uninsured family members.

ACP believes the programs should accomplish these goals:

  • Expand coverage to those who are currently uninsured, safeguarding against "crowding out," whereby employer-provided or other existing coverage is dropped in favor of new coverage;
  • Prevent funds from being diverted from providing health insurance to other purposes; and
  • Balance state flexibility and federal standards to ensure adequate benefits, quality standards, administrative simplicity and continuous coverage.

ACP chapters and members are encouraged to monitor state-level implementation and advocate on behalf of adolescent patients and for all uninsured. ACP supports state programs that are designed to accommodate future expansions, something that may be needed if employer-provided coverage continues to erode.

Elizabeth Prewitt is Senior Associate for Government Relations in ACP's Washington, D.C., office.

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