Archive for the ‘children’s health’ Category

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How the Affordable Care Act Helps Youth Aging Out of Foster Care

Wednesday, August 17th, 2011

Mandatory Medicaid coverage for former foster care youth who have aged out of the foster care system but are in care as of their eighteenth birthday—an important provision in the Affordable Care Act (ACA) that isn’t as widely known as it should be—is finally getting some traction thanks to a recent paper in the Michigan Journal of Social Work and Social Welfare.

Finding quality, affordable health insurance can often be difficult for youth transitioning out of the foster care system, and providing Medicaid coverage as a bridge during this pivotal time up to age 26 is an incredibly significant step forward. According to the paper’s author, Aisha Hunter (having herself aged out of the foster care system), “the 2014 foster youth health care expansion plan represents the most comprehensive and profound legislation for this population in decades.” Here at Community Catalyst’s New England Alliance for Children’s Health program, we couldn’t have said it better ourselves.

The foster youth expansion provision goes into effect beginning in 2014. It builds  upon the Foster Care Independence Act of 1999, which, among other things, gave states the option of extending Medicaid coverage to foster youth up to age 21 through the John Chafee Foster Care Independence Program (otherwise known as the “Chafee option”).

The paper also helpfully points out that, despite the difference  this ACA provision will make in the lives of youth aging out of the foster care system, there are important implementation issues that need to be addressed to make it as effective as possible. For instance, because all foster youth aging out of Medicaid will qualify for the program up to age 26, individual applications for enrollment are an unnecessary burden for the youth themselves as well as for parents and child welfare workers. Instead, an automatic enrollment process should be put into place to ensure these youth can easily take advantage of this important ACA benefit. Additionally, in order to ensure continuous health insurance coverage during this transitional period for youth, states should not be permitted to deny youth’s access to Medicaid simply because they have another potential source of coverage.

The extension of Medicaid coverage to youth aging out of the foster care system is another example of how the ACA is full of commonsense reforms that enhance access to care for those who need it most. When we hear overblown rhetoric about this historic law, it’s worth remembering that it’s already helping real people every day, and will help even more as time goes on.

—Patrick M. Tigue, Senior Policy Analyst

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It’s Time to Reauthorize Funding to Train Pediatricians (and Use Funding to Train Other Physicians More Effectively)

Wednesday, August 10th, 2011

It’s hard to imagine how children can stay healthy if there aren’t enough pediatricians to take care of them. And this is precisely the issue at stake as Congress decides whether to reauthorize the Children’s Hospitals Graduate Medical Education Payment Program (CHGME) over the coming weeks. The House Energy and Commerce Committee recently passed CHGME reauthorization legislation (H.R. 1852), and its companion bill (S. 958) is due to be considered by the Senate Health, Education, Labor, and Pensions Committee in early September. However, CHGME’s current authorization expires on September 30 of this year, and the ultimate fate of the reauthorization effort remains very much in doubt at this point.

Putting the debate in context
There was a real concern about the nation’s pediatric workforce in the late 1990s after the American Board of Pediatrics noted that the number of pediatric residents had seen a decline of more than 13 percent, and the Pediatric Education Task Force concluded that the lack of adequate federal funding for graduate medical education at independent children’s hospitals was a significant threat to maintaining an adequate number of pediatricians going forward.

To address this issue, Congress created CHGME 1999 so that independent children’s hospitals could receive federal support to train resident pediatricians and pediatric specialists similar to the support provided to adult hospitals through the Graduate Medical Education Program (GME) through Medicare. Prior to the enactment of CHGME, independent children’s hospitals were receiving only half of a percent of the federal funding provided to adult hospitals for GME as well as unstable and varying support from Medicaid.

And CHGME has worked exactly as Congress intended by increasing the number of pediatric residents and pediatric resident specialists training at independent children’s hospitals, meeting pediatric workforce development needs in geographic regions across the country, and ensuring that even children living in states without independent children’s hospitals have some access to well-trained pediatricians and pediatric specialists.

Success begets success
Given CHGME’s track record of success, advocates must remain vigilant to ensure that the program is reauthorized before it expires at the end of September. This becomes even more important given the shortage of pediatric specialists in many areas of the countrydespite the impressive progress made as a result of CHGME. Advocates can play an important role in the coming weeks by weighing in with their Congressional delegation.

For more information on CHGME, check out the new paper from our New England Alliance for Children’s Health program that outlines in greater detail the past success of CHGME, makes the case for why it is still needed, and offers some ideas about how to improve the program.

Training for docs for grown-ups needs help too…
It’s also worth noting that, unlike CHGME, the GME Program (aimed at training physicians who serve adults) receives a majority of its funding from Medicare to train medical residents. Currently, GME does not produce enough primary care providers to meet the country’s needs. Primary care is critical to fixing the health care system, and GME is one untapped tool for primary care workforce expansion, as outlined in another new paper we recently released. More can be done to redesign GME so that it is more nimble in its response to regional and national workforce needs. Policy makers have an opportunity to develop a framework of accountability that preserves our tradition of excellent medical education while tying it directly to the needs of consumers.

—Eva Marie Stahl, Policy Analyst
—Patrick M. Tigue, Senior Policy Analyst

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Solving the Specialty Care Issues for Medicaid and CHIP Children

Wednesday, June 22nd, 2011

The New York Times ran an article last week on the results of a new study published in The New England Journal of Medicine (NEJM) on access to outpatient specialty care for children on Medicaid and the Children’s Health Insurance Program (CHIP). The study found that children with public health insurance are much more likely to be denied specialty care or forced to wait for long periods of time for a specialist appointment than children with private health insurance. Medicaid and CHIP have been very successful in other important ways, but this study is concerning—particularly in the context of current proposals under discussion in Congress that would undermine these vital programs that provide a lifeline to millions of children as well as other vulnerable populations.

To conduct the study, research staff posed as parents and called specialty practices in Illinois to schedule appointments for their children. The two major findings from the study were:

  • – More than 66 percent of callers who said they had a child on Medicaid or CHIP were denied an appointment, compared to only 11 percent of callers who said they had a child on private insurance.
  • – The average wait time to see a specialist who accepted both public and private insurance was 22 days longer for Medicaid and CHIP children than for children with private insurance.

This study’s findings are consistent with the United States Department of Health and Human Services’ (HHS) 2010 literature review on access to care for Medicaid and CHIP children. HHS succinctly summarized its findings this way: “. . . access could be improved substantially for specialty care services (e.g., dental, mental health).” Reasons cited in the NEJM article for providers’ decisions not to treat patients covered by Medicaid and CHIP include: disparities in insurance reimbursement rates, delays in payment, and cumbersome payment procedures.

Access to specialty care for children on Medicaid and CHIP is clearly an issue that needs to be addressed. This begs the question of what effect current Congressional proposals to turn Medicaid into a block grant program, cap federal expenditures, or allow states to cut Medicaid and CHIP eligibility through repealing the Affordable Care Act’s maintenance of effort requirements (MOE) would have. The short answer is that all of these proposals would make this problem even worse. Block granting or a spending cap would result in reductions in Medicaid and CHIP spending, which would inevitably lead to provider rate cuts. Repealing the MOE provisions would result in reductions in overall coverage levels—leading to more uninsured children. Either way, these proposals would result in even less access to specialty care (not to mention to other essential health services as well).

Overall, Medicaid and CHIP serve our country’s children immensely well by providing cost-effective coverage for children that improves health outcomes and protects low-income families from financial ruin. For example, Medicaid and CHIP children actually fare very well when it comes to access to primary care. According to HHS, “Considerable evidence indicates that children enrolled in Medicaid/CHIP have much better access to primary care services than uninsured children and comparable access relative to privately insured children.”

In areas like access to specialty care, where further progress needs to be made, the answer is not to undermine these programs by reducing our investment in them. Instead, we need to implement innovative policy proposals that create savings in Medicaid by improving the health care delivery system, and that can be used to address outstanding issues like access to specialty care as well as for deficit reduction. And it’s up to all of us to make sure that members of Congress understand that we need thoughtful solutions to our nation’s problems, not mindless cuts.

—Patrick M. Tigue, Children’s Health Care Coordinator
New England Alliance for Children’s Health

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Cross-Post: Got Coverage? 1,479 More Kids in MA Do Now!

Wednesday, June 15th, 2011

Massachusetts health advocacy organization Health Care for All (HCFA) sponsored a month-long campaign to enroll as many uninsured children in health coverage as possible. HCFA enlisted 66 organizations across the state to participate in its Statewide Enrollment Challenge, part of U.S. Health and Human Services Secretary Kathleen Sebelius’s “Connecting Kids to Coverage” campaign. Three of the state’s major insurance providers donated awards for the six most successful Challenge participants.

This blog was originally posted on Health Care for All’s A Healthy Blog.

It’s been a whirlwind month, but the first phase of the “got coverage?” Kids Enrollment Challenge is DONE! And thanks to the tireless efforts of 66 enrollment organizations statewide, HCFA is proud to announce that 1,479 previously uninsured children now have health coverage!!

The end of the first phase was celebrated today at an event at the State House Grand Staircase, where state and federal leaders extended their gratitude to each of the participating organizations for their devotion and hard work over the last month to find and enroll at least 500 uninsured children. Nearly tripling our goal, we couldn’t be more grateful to these groups for standing up for kids.

Christie Hager, Regional Director of the U.S. Department of Health and Human Services, Senator Sal DiDomenico, and Representatives Tackey Chan, Russell Holmes, Elizabeth Malia, Ellen Story and Alice Wolf were all in attendance to show their appreciation.

In speaking to the organizations, Rep. Story said that state leaders are asked to do a lot of hard and sometimes impossible tasks, but that she knows it is not too hard or impossible to get twelve-month eligibility for families and children. “It’s a no-brainer!” she exclaimed.

But the best appreciation came from the children and families who finally find themselves with insurance after years of no health coverage. Dennis Chang, father of two girls, told us that even though you cannot see his daughter’s illness, it is still there and he is grateful for the coverage he now has to pay for her doctor’s visits. Sonia Costa’s child was born prematurely and she says getting health care coverage made all the difference. Vilma Donis, who found out about the program through church, merely sighed “Thank God!” once she, her son and daughter were enrolled in coverage. Obviously, the work of each of the 66 enrollment organizations will yield healthier outcomes for generations to come.

Today’s event was multipurpose, as it allowed HCFA to both celebrate these organizations and to also kick off the next phase of its enrollment challenge: helping kids retain their health care coverage.

Many participating enrollment groups found that the reason children lack health insurance is because parents are often not sure how or when to reenroll their kids each year. In an effort to address this issue, HCFA has asked these organizations to continue to help keep those kids connected to care by advising parents about the best ways to stay enrolled. For the second phase of the challenge, HCFA has provided participating organizations with educational outreach materials, including bookmarks and magnets, which detail the steps of how to maintain health coverage. These materials feature actionable reminders, such as informing MassHealth about changes in employment status or address, and when their family’s health insurance renewal is due.

We were so pleased with the organizations’ enthusiasm to sign on to the next phase to focus on coverage retention! Got coverage? 1,479 kids do now!!

-Katy Capers, Health Care for All

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The Complexity of Covering Children

Tuesday, June 14th, 2011

Positive trends in children’s coverage made the news last week, with the Urban Institute reporting that 1.1 million children gained health coverage through Medicaid and CHIP between 2007 and 2009. While these coverage gains are quite impressive, they may soon be overshadowed by less desirable developments. A number of different factors could result in children’s coverage rates heading in the wrong direction in years to come.

First and foremost, the proposed Medicaid and CHIP cuts and program changes currently being debated (such as eliminating the maintenance of effort (MOE) requirement that protects eligibility standards or converting Medicaid funding into a block grant) would undoubtedly result in children losing coverage. The Congressional Budget Office estimates that repealing the MOE requirement would result in half of all states eliminating their CHIP programs and 1.7 million children losing access to CHIP by 2016.

A second and somewhat lesser-known challenge for keeping kids covered will be dealing with “complex coverage situations” when the Affordable Care Act (ACA) is fully implemented in 2014. “Complex coverage situations” are scenarios in which children are not covered by the same insurance program as their parent(s) or do not live in the same household as at least one parent. These circumstances can make finding, enrolling in, and retaining health coverage for children complicated and confusing – especially in 2014 when millions more people qualify for Medicaid, state insurance Exchanges officially roll-out, and parents are held newly accountable for obtaining coverage for their children.

According to a recent Urban Institute report, almost 42 million children fall under at least one of these “complex coverage” categories:

  • – 20.7 million children are eligible for different insurance programs than other family members (either because a parent’s employer-sponsored insurance does not cover dependents or because children qualify for Medicaid or CHIP and their parents do not)
  • – 27.7 million children live apart from at least one of their parents
  • – 6.5 million children fall into both categories

Many questions about how specific situations will be handed in 2014 remain unanswered. For example, if a parent has employer-sponsored coverage for herself but needs to buy a child-only policy in the Exchange, will her contributions to the employer policy be considered in determining the amount deemed affordable for the child-only policy? And will a parent who claims a child on his tax forms be penalized for not covering this child if a medical support order (a form of child support provided as health insurance under a parent’s policy) deems a different guardian responsible?

Policymakers must begin working now to answer these questions and ensure that children in complex coverage situations benefit from the ACA. Subsidy determination processes must be clarified, outreach and enrollment strategies for children who qualify for different programs than their parents must be developed and implemented, and medical support orders must be made more consistent with the ACA’s coverage requirements. Failure to resolve these issues now may mean future coverage losses for some children—something none of us want to see.

—Maia Fedyszyn, Program Associate
New England Alliance for Children’s Health

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Recent Polls Find Strong Support for Taxing Sugar-Sweetened Beverages

Tuesday, May 17th, 2011

Childhood obesity is truly an epidemic. More than one in six children in the United States are obese, a rate that has tripled in the past 30 years. Childhood obesity is linked to a number of debilitating and costly diseases, including cardiovascular disease, diabetes, hypertension, several kinds of cancer, and other chronic conditions.

A significant body of research has demonstrated that consumption of sugar-sweetened beverages (SSBs) — such as sodas, sports drinks, and sweetened teas — is strongly linked to increased obesity in children. This is why various proposals to tax SSBs as a means of reducing consumption and raising revenues for initiatives to fight childhood obesity have been the focus of intense discussion in 14 states during 2011 alone.

A recent poll commissioned by The Boston Foundation and NEHI as part of their Healthy People/Healthy Economy coalition’s work found that 69 percent of Massachusetts voters would support applying the state sales tax to soda and candy (these items are currently exempt) if the revenues from the tax were used to fund childhood obesity reduction efforts. The Alliance for a Healthier Vermont also recently conducted a poll that found a similar result, with nearly 60 percent of Vermont residents expressing support for a penny-per-ounce excise tax on SSBs.

These poll results should encourage all of us who are deeply concerned about the childhood obesity epidemic to press forward with taxation proposals and continue to work to strategically engage the public about the importance of using a variety of policy tools to make progress in the fight against childhood obesity. Our children deserve a healthy future and taxing SSBs is one important way to help ensure this. These polls suggest that the public thinks so as well.

—Patrick M. Tigue, Children’s Health Care Coordinator
New England Alliance for Children’s Health

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On This Mother’s Day, the Affordable Care Act Keeps Working for Our Children

Monday, May 9th, 2011

Having celebrated Mother’s Day with my mom this past weekend, I know that despite leaving home over a decade ago, she’s still always looking out for me. And she is not alone. Moms (and dads, too) across the country are making sure their young adult children are well taken care of even after they leave home by adding them on to their health insurance plans. Most young adults under 26 are eligible to remain on their parents’ plans if they don’t yet have access to employer-sponsored plans.

This provision from the Affordable Care Act (ACA) was always very popular with the public—but until recently, no one was sure just how successful it would be. Initial indicators suggest this option may turn out to be an even bigger success than many of us originally anticipated.

The United States Department of Health and Human Services (HHS) previously produced a mid-range estimate that projected 1.2 million young adults to gain new coverage under this provision in 2011. Just last week, it was reported that at least 600,000 young adults have already been added to their parents’ plan — and we’re just a third of the way through the year. This suggests that there’s a shot to reach the high estimate prepared by HHS of over 2.1 million young adults gaining new coverage in this year alone.

Another piece of good news is that young adult children in military families are also eligible to take advantage of this option. Eligible children of service members up to age 26 can purchase health care coverage under their parents’ TRICARE plans, retroactive to January 1, 2011. These children were not originally included in the ACA provision and, until this year, lost access to their parents’ plans at age 21 (or 23 for full-time college students).

If you’re interested in learning more about the ACA young adult coverage provision, check out both this blog post by HHS Secretary Sebelius as well as the state-specific resources prepared by our partners at Young Invincibles at their Getting Covered website. We’ve also blogged about the young adult provision previously.

The ACA’s success in improving young adults’ access to health insurance coverage is just one of many ways that it’s helping children. Don’t forget that the ACA also requires that insurers cover children with pre-existing conditions and increases access to preventive care by eliminating cost-sharing for preventive services.

In short, the ACA is giving moms across the nation reason to feel confident that their children have better access to coverage and care. Healthy children — now there’s something every mom wants for Mother’s Day!

—Patrick M. Tigue, Children’s Health Care Coordinator
New England Alliance for Children’s Health

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Ryan’s Plan CHIP-ing Away at Children’s Coverage

Monday, April 11th, 2011

House Budget Committee Chairman Paul Ryan’s Federal Fiscal Year 2012 budget blueprint, dubiously titled The Path to Prosperity, has damaging implications for children’s health. The Republican budget plan would dramatically cut funding for Medicaid and the Children’s Health Insurance Program (CHIP), health insurance programs that cover about 30 million children—almost a third of all children living in our country today.

Chairman Ryan would cut Medicaid and CHIP by a staggering $2 trillion over the next 10 years by doing the following:

  1. Slashing the Medicaid Budget: Ryan’s proposal would cut $771 billion in federal spending from the Medicaid program. According to the Congressional Budget Office, “federal spending for Medicaid would be 35 percent lower in 2022 and 49 percent lower in 2030 than currently projected.”
  2. Transforming Medicaid into a Block Grant: Under a block grant, states that use up their federal Medicaid allotment will no longer be able to receive additional federal funds when costs go up or enrollment increases. Cash-strapped states will be left high and dry, and will have to make up the difference by raising taxes, cutting other spending, or shrinking their Medicaid programs.
  3. Repealing the Affordable Care Act: Ryan’s blueprint repeals most of the new health law’s major provisions, including its language extending CHIP through 2019 and fully funding the program through 2015. This means that CHIP would not receive any federal funding past 2013, its reauthorization date prior to the Affordable Care Act’s (ACA) two-year funding extension. Repealing the ACA would also cut an additional $627 billion from Medicaid—bringing total Medicaid cuts to $1.4 trillion—and would have a host of other detrimental effects on children’s access to quality health care.

States will have to fill in these funding gaps somehow, which could mean cutting reimbursement rates to providers and hospitals, limiting benefits, or reducing eligibility levels. No matter how states work to fill in these gaps, children are likely to lose out. Children represent half of all Medicaid enrollees, but account for only 20 percent of Medicaid spending—meaning that huge numbers of children could be adversely affected by program cuts yet save the federal government comparatively little money.

The impact of limiting benefits is particularly concerning for children. As Jocelyn Guyer from the Georgetown Center for Children and Families points out in a recent Say Ahhh! blog post, families rely on these programs “for hearing tests and glasses so their children can grow and learn, as well as for physicals so they can play sports. In many families, Medicaid provides children with the medical care that they need so they can thrive in the face of common medical conditions such as asthma and ADHD.”

While Ryan’s budget proposal may be a path to prosperity if you’re a wealthy individual or corporation in line to receive some $1.8 trillion in tax cuts, it certainly isn’t a path to prosperity if you’re a family who depends on Medicaid or CHIP for your child’s asthma medications, eye tests, or flu shots. Our nation cannot afford to ignore the needs of its children. We can and should do better.

—Maia Fedyszyn, Program Associate, New England Alliance for Children’s Health

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$25 Million to Tackle Childhood Obesity in Medicaid, CHIP, and Beyond

Thursday, February 10th, 2011

Many of you may recall that the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) authorized childhood obesity demonstration grants aimed at developing an effective model for reducing obesity in children. Thanks to the Affordable Care Act, $25 million in funding was made available for these grants. With this funding now available, the US Department of Health and Human Services (HHS) recently released the funding opportunity announcement to solicit applications.

The goal of the CHIPRA childhood obesity demonstration grants is to determine whether an integrated model of primary care and public health approaches can improve underserved children’s risk factors for obesity. These approaches may include policy, systems, and environmental supports that encourage nutrition and physical activity for children and their families.

HHS plans to award only three grants; each will be approximately $6.25 million spread out over a four year period. HHS will also make a separate award of approximately $4.25 million to an evaluation center to assess the success of the three demonstration projects.

A call and webcast for prospective applicants will be held on February 16, 2011 from 4:00 P.M. to 5:45 P.M. Eastern Standard Time. The call-in information is as follows:

Call-In Number: (888) 843-9981
Passcode: 3004616

For additional information about the call and webcast, please see the funding opportunity announcement. Optional (but encouraged) letters of intent are due by February 22, 2011 with the final application due on April 8, 2011.

Here at the New England Alliance for Children’s Health, an initiative of Community Catalyst, we find this type of approach to the childhood obesity epidemic to be very exciting because we believe it will be an important step toward what our partners at the National Initiative for Children’s Healthcare Quality (NICHQ) have called “the system framework for addressing obesity” that includes changing “the policy environment, at both the societal and organizational levels.” This type of a framework will allow the childhood obesity epidemic to be addressed from multiple angles to ensure that progress will be made.

—Patrick M. Tigue, Children’s Health Care Coordinator
New England Alliance for Children’s Health

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Happy Second Anniversary, CHIPRA!

Friday, February 4th, 2011

While the uninsurance rate for adults has risen in recent years, the opposite is true for children: fewer and fewer children are going without health care coverage. This steady decline in uninsured children is due in part to the fact that children’s public insurance programs—Medicaid and the Children’s Health Insurance Program (CHIP)—have become stronger and more accessible at a time when children and families need them most. And much of the credit for the recent strengthening of these programs belongs to the Children’s Health Insurance Program Reauthorization Act (CHIPRA), signed into law by President Obama exactly two years ago today. Happy second anniversary, CHIPRA!

CHIPRA provides states with incentives (in the form of bonus payments) to enact enrollment and retention simplification measures to improve coverage rates, offers grants for conducting innovative outreach, enrollment and quality-improvement activities. It also authorizes new policy options like Express Lane Eligibility, coverage of pregnant women in CHIP, and removal of the five-year waiting period for lawfully residing immigrant children and pregnant women to enroll in public insurance.

All of these new financial resources and policy options have enabled states to make significant improvements to their children’s health programs in a very short amount of time. In 2010 alone, 13 states expanded eligibility, 14 states made improvements in enrollment and renewal procedures, and 15 states qualified for bonus payments. Nationwide, Medicaid and CHIP programs for children are more comprehensive and efficient than ever. According to the recently-released 2010 CHIPRA Annual Report:

– 46 states and the District of Columbia now cover children with incomes up to 200 percent of the Federal Poverty Level (FPL) ($44,700 for a family of four).
– 22 states now offer coverage to lawfully residing immigrant children and/or pregnant women.
– 48 states and the District of Columbia have a 12 month eligibility period for Medicaid and CHIP and 23 states offer 12 months of continuous eligibility.
– 32 states have an on-line application that can be submitted electronically and 29 states allow electronic signatures on applications.
– 33 states and the District of Columbia are utilizing the data matching process provided by the Social Security Administration to confirm U.S. citizenship for children in Medicaid.

Thanks in part to these program enhancements and eligibility improvements, over two million children gained Medicaid or CHIP coverage during federal fiscal year 2010, with the programs serving more than 42 million children during this timeframe. These numbers should continue to rise in the years to come, as outreach, enrollment and retention efforts ramp up thanks to a new round of outreach and enrollment grants and U.S. Department of Health and Human Services Secretary Kathleen Sebelius’ Connecting Kids to Coverage Challenge, which aims to enroll five million eligible but uninsured children in Medicaid and CHIP by 2015.

Yet there is a chance that coverage for children will not continue to move in the right direction. If Republican governors get their way and states no longer have to comply with the Affordable Care Act’s Maintenance of Effort (MoE) requirement, coverage for millions of children in CHIP and optional Medicaid expansions could be eliminated. States could also impose “back door” cuts by using red tape barriers to make it harder for children to sign up for coverage. For example, programs could reinstate face-to-face interviews or shorten eligibility periods.

We cannot afford to let this happen. We need strong Medicaid and CHIP programs to create a solid foundation for the full implementation of the Affordable Care Act in 2014 and to ensure that our nation’s children have the coverage they need to stay healthy. Eliminating the MoE requirement would be a penny-wise and pound-foolish way to address budget shortfalls. After all, let’s not forget about what’s at stake here: the health and well-being of our nation’s children.

—Maia Fedyszyn, Program Associate
New England Alliance for Children’s Health

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