That PCCY has waged an epic war on any and all public policy that doesn’t benefit the health and welfare of children is notable, but its battles for children’s health are legendary and relentless.
PCCY is widely credited with helping establish one of Pennsylvania’s crowning jewels, a one-of-a-kind program designed to provide insurance coverage to children whose families earn too much to qualify for Medical Assistance, but who could not afford to purchase private insurance—Children’s Health Insurance Program, better known as CHIP.
On December 2, 1992, former Governor Robert P. Casey signed into law House Bill 20 (HB 20). CHIP provides coverage for more than 100,000 children annually. Pennsylvania’s CHIP program would later be used as the model for the federal government’s CHIP program. But for years before that landmark, PCCY was hyper focused on the fight for access to health care for children even before birth.
In 1989, Congress expanded the Medicaid program guaranteeing early and periodic screening, diagnostic and treatment (EPSDT) services for hundreds of thousands of low-income children. Mostly from working poor families, these children became eligible for free services deemed medically necessary by a doctor, and PCCY becomes a relentless watchdog for children’s health.
Many of these battles don’t make headlines but make a huge difference in the lives of children, and PCCY’s fingerprints are all over them. Even the name of a program – EPSDT – is in PCCY’s sites. PCCY repeatedly suggests renaming it ‘Free Health Care for Children.’ PCCY is integral in establishing alcohol consumption warnings in Philadelphia taverns. Year after year, PCCY brings the stories of young mothers struggling to navigate the unwieldy system to the policymakers charged with implementing them, and fight to advance their rights.
In 1990, PCCY Health Committee Chairperson, Donald Schwartz, MD., testifies to the US Senate Government Affairs Subcommittee on General Services and Federalism, urging consistency and ease of use for all government programs helping poor people gain access to health coverage. During his testimony, he underscores the story of a 15-year-old teenage mother named Lakita, caught in the system and unable to access care for herself and her newborn due to needless restrictions and difficult eligibility requirements.
Following the implementation of CHIP, PCCY continues to battle by anticipating potential cuts and offering impassioned appeals that the state’s elected officials must stand firm in their commitment to kids – despite the economic woes of the day.
Challenges with access persist, as little promotion of free health care, even to caseworks in the Department of Public Welfare, leave what little information that is available to families out of reach. PCCY steps in, and in an effort to close the gap they eventually begin enrolling families themselves.
Recognizing that school nurses and counselors are on the front line of children’s health care and are often the first and only consistent source of assistance with the health care system for their parents, PCCY begins publishing “The Manual for School Nurses and Counselors in Southeastern Pennsylvania”.
The Child Health Watch Helpline is established to assist families in finding health insurance for their children. They help with applications for public health insurance, either Medical Assistance (MA) or the Children’s Health Insurance Program (CHIP), and resolve enrollment problems. This service is free and is available in any language. Helpline staff also helps families find health care services such as primary care, dental, vision, and behavioral health care that they can access with or without insurance.
In 2006, the Pennsylvania legislature enacted Cover All Kids – a sweeping reform of the CHIP program that extended coverage to almost all children – all children except those who do “not meet the citizenship requirements of Title XXI of the Social Security Act.” These 13 words bar children whose parents entered the county with them illegally from enrolling in the state’s CHIP program.
In 2009, PCCY warriors headed to Harrisburg to hand legislators spinach cans emblazoned with the slogan ‘Be Strong for Pennsylvania’s Kids.’ Encouraging them to be strong for kids and recognize the importance of prioritizing children’s programs in the budget, toddlers presented legislative aides spinach cans that listed child care, pre-k and CHIP as programs that must be fully funded.
The spinach cans also awaited the members of the House Appropriations Committee at their desks as they arrived at the Majority Caucus Room to debate Senate Bill 850 that would have made deep program cuts. Governor Ed Rendell was handed his spinach can during a public appearance in Delaware County, where he publicly pledged to protect CHIP funding from the budget axe.
In January 2014, a new initiative to expand Medicaid coverage called “Healthy PA” is launched. PCCY implores the state to make children who are undocumented eligible for public health insurance and to transition more children into Medicaid as the Affordable Care Act required. The Affordable Care Act mandates that states shift very low-income children from CHIP to the Medicaid program, because Medicaid typically offers more robust health benefits for children.
Coverage is still missing for some people in the Healthy PA plan – specifically for the estimated 47,000 vulnerable children who live in the commonwealth and are undocumented and most likely uninsured. An estimated 5,700 uninsured children are not eligible for coverage because they are undocumented, and consequently they often face sizable barriers to care.
Healthy PA has already done some good for children. The Governor and the legislature immediately acted on the Healthy PA proposal to eliminate a waiting period for some children to get into CHIP and they reauthorized the program as well. But PCCY persists, as Healthy PA can do better for more children and require that truly all kids be covered.
Every child should be able to see a doctor when they get sick. In southeastern Pennsylvania, more than 46,000 children do not have health insurance. Facing these stark facts, PCCY regularly convenes the Southeast PA Children’s Health Insurance Coalition to raise awareness about children’s public health insurance policy and procedural changes, identify new barriers to enrollment or access to health care services and advocacy strategies to address them.
Coalition members include a cross-section of southeastern PA organizations and individuals that directly enroll children in public health insurance and/or that engage in advocacy and policy work related to children’s public health insurance.
PCCY won’t stop until the true meaning of Pennsylvania’s Cover All Kids program is realized with every child qualified for coverage. In 2019, more than 20,000 suburban children had no health insurance – and the majority of them qualify for public health insurance – either Medical Assistance or the Children’s Health Insurance Program (CHIP). Before the dawn of PCCY, CHIP did not exist.